Individual
CHELSEA PROVENZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP- C
Contact information
Practice address
8851 CENTER DR STE 408, LA MESA, CA 91942-3076
(619) 583-1174
(619) 583-4609
Mailing address
13627 SUNSET VIEW RD, POWAY, CA 92064-5051
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95006939
CA
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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