Individual
ERIC PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
574 PLEASANT AVE, EUREKA, CA 95503-6521
(916) 467-9453
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
08/05/2025
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