Maria Provencher

Primary specialty

DoulaTaxonomy code 374J00000X

Practice address

5638 Lake Murray Blvd Ste 332
La Mesa, CA 91942-1929

Phone

(619) 481-8691

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1871098509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 LAKE MURRAY BLVD STE 332",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421929",
            "telephone_number": "619-481-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 LAKE MURRAY BLVD STE 332",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421929",
            "telephone_number": "619-481-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCHER",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prasad Gonavarum D.D.S., Professional Corporation (Smiles of La Mesa)
• Allyson M Prather, MFT
• Susan Patricia Press, DMD
• Mark Priest
• Katherine Prince
• Chelsea Provenzano, MSN, FNP- C
• Renee Prueitt, LMFT
• Psychological & Family Support Services, Inc
• Gabriela Alexa Puentes, OTR/L
• Savannah Puett, DDS

• Doula in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Doula in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.