Provider Demographics
NPI:1033993175
Name:DOWD, JASON STEWART
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:STEWART
Last Name:DOWD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49690 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-8518
Mailing Address - Country:US
Mailing Address - Phone:503-550-3795
Mailing Address - Fax:
Practice Address - Street 1:69930 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-2850
Practice Address - Country:US
Practice Address - Phone:760-992-3039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician