Provider Demographics
NPI:1295392496
Name:PROULX, WILLIAM P
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:PROULX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:P
Other - Last Name:PROULX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:500 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2515
Mailing Address - Country:US
Mailing Address - Phone:831-757-4633
Mailing Address - Fax:831-757-1241
Practice Address - Street 1:500 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2515
Practice Address - Country:US
Practice Address - Phone:831-757-4633
Practice Address - Fax:831-757-1241
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator