JENNIFER IRENE PROVOST (NPI# 1447613427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447613427 |
| Entity Type | Individual |
| Full Name | JENNIFER IRENE PROVOST |
| Practice Address |
2844 Coloma St Placerville CA 95667-4406 |
| Mailing Address |
5725 Main Ave Apt 22 Orangevale CA 95662-5446 |
| Practice Telephone | 5306269240 |
| Mailing Telephone | 9162044293 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316304520 | Jennifer Provost | Skilled Nursing Facility | 310 Terrace Dr, Bartlett, IL 60103-4462 | 2016-01-19 |
| 1427694629 | Jennifer Provost | Counselor | 11 Robinson St, Pottstown, PA 19464-6421 | 2019-11-22 |
| Street Address |
2844 COLOMA ST |
| City | PLACERVILLE |
| State | CA |
| Zip Code | 95667-4406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366553612 | Linda Ann Marx | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2006-08-31 |
| 1053929810 | Stephanie J Schmidt | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2020-07-17 |
| 1831716331 | Kyle William Case | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2020-06-30 |
| 1346875465 | Autumn Schmidt | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2020-03-09 |
| 1346887122 | Robert Francis Pease Jr. | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2019-11-29 |
| 1912553702 | Kimberlee Ilise Mattingley | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2019-08-16 |
| 1003475062 | Yvonne Martinez Thomas | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2019-06-12 |
| 1902370604 | Cameron James Davis | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2019-01-15 |
| 1285119503 | Sheila M Veith | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2018-10-02 |
| 1598240988 | April Kerwin | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2018-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1497390041 | Summitview Child & Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3025 Glee Ln, Placerville, CA 95667 | 2019-11-07 |
| 1225694474 | Camille Borba | Doula | 1212 Lotus Rd, Placerville, CA 95667 | 2019-05-14 |
| 1033610399 | Julie Marie Halsall | Counselor | 2844 Coloma Street, Placerville, CA 95667 | 2018-02-22 |
| 1053839092 | County of El Dorado | Community/Behavioral Health | 3057 Briw Road, Suite A, Placerville, CA 95667 | 2017-08-30 |
| 1982129508 | Brent Charles Ulrici | Counselor | 2986 Colma St, Placerville, CA 95667 | 2017-08-04 |
| 1629464326 | Crystal Coury | Counselor | 5607 Mount Murphy Roas, Garden Valley, CA 95667 | 2015-04-09 |
| 1396141750 | Brown and Ghazal Dental Corporation | Dentist | 3967 Missouri Flat Road, Suite 120, Placerville, CA 95667 | 2014-11-13 |
| 1962808402 | Laura Ann Curry | Counselor | 6765 Green Valley Road, Placerville, CA 95667 | 2014-11-11 |
| 1518374453 | Kelly Lynn Carson | Counselor | 2844 Colona St., Placerville, CA 95667 | 2014-07-11 |
| Find all providers in zip 95667 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245728625 | Eric Hill | Counselor | 2905 Cold Springs Rd, Placerville, CA 95667-4219 | 2018-05-01 |
| 1033610399 | Julie Marie Halsall | Counselor | 2844 Coloma Street, Placerville, CA 95667 | 2018-02-22 |
| 1982129508 | Brent Charles Ulrici | Counselor | 2986 Colma St, Placerville, CA 95667 | 2017-08-04 |
| 1750766937 | Janna Wallace | Counselor | 6387 Mother Lode Dr Spc 78, Placerville, CA 95667-8225 | 2015-07-29 |
| 1962808402 | Laura Ann Curry | Counselor | 6765 Green Valley Road, Placerville, CA 95667 | 2014-11-11 |
| 1518374453 | Kelly Lynn Carson | Counselor | 2844 Colona St., Placerville, CA 95667 | 2014-07-11 |
| 1891815940 | Diana Lynn Foster | Counselor | 550 Main St Ste I, Placerville, CA 95667-5634 | 2007-03-30 |
| 1174653547 | Nannette Bruhn-harney | Counselor | 4535 Missouri Flat Rd Ste 200d, Placerville, CA 95667-6808 | 2007-03-06 |
| 1366553612 | Linda Ann Marx | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2006-08-31 |
| 1053929810 | Stephanie J Schmidt | Counselor | 2844 Coloma St, Placerville, CA 95667-4406 | 2020-07-17 |
| Find all providers in PLACERVILLE | ||||
| City | PLACERVILLE |
| Zip Code | 95667 |
Please comment or provide details below to improve the information on JENNIFER IRENE PROVOST.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.