Individual
HEATHER LYNNE PROVENCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1101 VAN NESS AVE, SAN FRANCISCO, CA 94109-6919
(415) 600-6000
Mailing address
1101 VAN NESS AVE, SAN FRANCISCO, CA 94109-6919
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A125198
CA
Other
Enumeration date
03/28/2011
Last updated
08/28/2024
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