Individual
DR. CAROLINE ANN PROUVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13217 JAMBOREE RD #161, TUSTIN, CA 92782
(714) 253-7710
Mailing address
13217 JAMBOREE RD #161, TUSTIN, CA 92782
(714) 253-7710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
Primary
PSY30457
CA
Other
Enumeration date
08/07/2012
Last updated
04/30/2026
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