Marisa Provenzano, LCSW
NPI #1003707522 in San Diego, California
Provider Information
- NPI Number
- 1003707522
- Entity Type
- Individual
- Name
- Marisa Provenzano, LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Jul 12, 2025
- Last Updated
- Jul 12, 2025
Practice Location
- Address
- 5060 SHOREHAM PL STE 100
- City
- San Diego
- State
- California
- ZIP Code
- 92122-5904
- Phone
- (877) 840-6956
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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