Graduated: 2015
NPI: 1760848840
Practice Locations (2)
PROVIDENCE FACEY MEDICAL FOUNDATION
9111 CORBIN AVE
NORTHRIDGE, CA 913242402
8187435700
PROVIDENCE FACEY MEDICAL FOUNDATION
19950 RINALDI ST
PORTER RANCH, CA 913264141
8184032400
Source: CMS National Downloadable File, September 2026.