AUGUSTINE PROVENCIO MS
NPI 1629810270
Psychologist in Santa Monica, CA

NPI Status: Active since June 12, 2024

Contact Information

1339 20TH ST
SANTA MONICA, CA
ZIP 90404
Phone: (310) 829-8708

Recently Updated NPI Information
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.

Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Psychologist

About AUGUSTINE PROVENCIO

This page provides the complete NPI Profile along with additional information for Augustine Provencio, a provider established in Santa Monica, California with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1629810270 assigned on June 2024. The practitioner's primary taxonomy code is 103T00000X. The provider is registered as an individual and his NPI record was last updated July 2025.

NPI: 1629810270
Provider Name: AUGUSTINE PROVENCIO MS
Gender: Male
Entity Type: Individual
Location Address: 1339 20TH ST SANTA MONICA, CA 90404
Location Phone: (310) 829-8708
Mailing Address: 2779 GOLDENROD CT MERCED, CA 95340
Mailing Phone: (209) 756-2632
Is Sole Proprietor?: Yes
Enumeration Date: 06-12-2024
Last Update Date: 07-21-2025
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A psychologist like Augustine Provencio studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Psychologist
Taxonomy Code: 103T00000X
Type: Behavioral Health & Social Service Providers
Taxonomy Description: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	103TC2200X	Behavioral Health & Social Service Providers	Psychologist Clinical Child & Adolescent

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	6	2	9	8	1	0	2	7	0
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	6	4	9	16	1	0	2	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 4 + 9 + 1 + 6 + 1 + 0 + 2 + 1 + 4 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
									0

The NPI number 1629810270 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

GAIL GUTIERREZ ASW

Social Worker

(Clinical)

1339 20TH ST
SANTA MONICA, CA
ZIP 90404

About AUGUSTINE PROVENCIO

Location Map

Specialty - Primary Taxonomy

Psychologist

Secondary Taxonomies

Psychologist Clinical Child & Adolescent

Reviews for AUGUSTINE PROVENCIO MS

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is Augustine Provencio's NPI number?

Where is the provider located?

What is the provider's specialty?

Psychologist
Clinical Child & Adolescent