Provider Demographics
NPI:1043314404
Name:GOWANS, DENNIS E (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:GOWANS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7624 PAINTER AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2300
Mailing Address - Country:US
Mailing Address - Phone:562-945-6471
Mailing Address - Fax:562-945-9702
Practice Address - Street 1:7624 PAINTER AVE
Practice Address - Street 2:STE 200
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2300
Practice Address - Country:US
Practice Address - Phone:562-945-6471
Practice Address - Fax:562-945-9702
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6174103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP6174Medicare ID - Type Unspecified