DESTINY PROVENCIO

Behavior Technician

Active Individual
NPI: 1790505824

Practice Address

1063 MCGAW AVE STE 100
Irvine, CA 92614

Phone: (949) 594-6582

Specialties

Specialty Code Primary License
Behavior Technician 106S00000X Yes -

Frequently Asked Questions

NPI 1790505824 is the National Provider Identifier for DESTINY PROVENCIO, a Behavior Technician provider located in Irvine, CA. This NPI was enumerated on October 14, 2024.
DESTINY PROVENCIO practices at 1063 MCGAW AVE STE 100, Irvine, CA 92614.

Quick Facts

NPI
1790505824
Type
Individual
Enumerated
Oct 14, 2024
Last Updated
Nov 6, 2024

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