Provider Demographics
NPI:1043348576
Name:BOWMAN, BRIAN DAVID (MASTERS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 SUTTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1024
Mailing Address - Country:US
Mailing Address - Phone:916-492-7240
Mailing Address - Fax:916-736-1072
Practice Address - Street 1:1815 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6653
Practice Address - Country:US
Practice Address - Phone:916-492-7240
Practice Address - Fax:916-736-1072
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor