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NPI Code Detail

MEDICARE: MS. NAOMI PROCHOVNICK

MEDICARE: MS. NAOMI PROCHOVNICK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health WorkerCA
2101Y00000XCounselor

General Provider Information

NPI Number : 1659074847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NAOMI PROCHOVNICK
Provider Business Mailing Address
First Line : 98 PARKRIDGE DR APT 305
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94131-3430
Country : US
Telephone Number : 414-152-7957
Fax Number :
Provider Business Practice Location Address
First Line : 709 5TH AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-3202
Country : US
Telephone Number : 415-991-3765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2023
Last Update Date : 07/18/2023

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