Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Augie N. Provencio

Individual provider Family Medicine Physician · NPI 1467590158

Augie N. Provencio is a Family Practice in Livingston, California. Graduated from New York Medical College in 1988, 38 years ago. Practices with Timothy S Johnston MD PC, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Alaska, Arizona and California.

Years since qualifying
38
Trained at
New York Medical College
Licensed in
AK, AZ, CA
In the registry since
2007
Specialties on file
3
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

600 B St Bldg A-C
Livingston, CA 95334-9593
Phone: (209) 850-3500
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 W Hospital Dr, Whiteriver, AZ 85941 — (928) 338-4911

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A48099 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 36333 (AZ)
Family Medicine Physician Taxonomy 207Q00000X · Licence 3673 (AK)

Record details

NPI number1467590158
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 2, 2007
Last updated in NPPESMarch 23, 2022
Certification dateMarch 16, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesEMERGENCY MEDICINE
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 1988 (38 years in practice)
Group practice Timothy S Johnston Md Pc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Livingston