Provider Demographics
NPI:1093996902
Name:DOWDALL, SAMANTHA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ANN
Last Name:DOWDALL
Suffix:
Gender:F
Credentials:PHD
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Other - First Name:
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Mailing Address - Street 1:3880 S BASCOM AVE
Mailing Address - Street 2:SUITE 116A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2674
Mailing Address - Country:US
Mailing Address - Phone:408-377-7600
Mailing Address - Fax:408-377-7615
Practice Address - Street 1:3880 S BASCOM AVE
Practice Address - Street 2:SUITE 116A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2674
Practice Address - Country:US
Practice Address - Phone:408-377-7600
Practice Address - Fax:408-377-7615
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY17880103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical