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Contact Information

KARI L PROVOST, PA
12595 HESPERIA RD STE 101
VICTORVILLE, CA92395
 Phone: 760-881-3377
 Fax: 760-881-3379
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KARI L PROVOST · (Female)

NPI # 1376892521
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 09/04/2012
Last updated 07/30/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA22507
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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