Provider Demographics
NPI:1093905929
Name:STOWE, DEBRA IRENE (MSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:IRENE
Last Name:STOWE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 FLYNN RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8704
Mailing Address - Country:US
Mailing Address - Phone:805-445-7800
Mailing Address - Fax:805-482-0973
Practice Address - Street 1:975 FLYNN RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8704
Practice Address - Country:US
Practice Address - Phone:805-445-7800
Practice Address - Fax:805-482-0973
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAASW274571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health