Provider Demographics
NPI:1144394867
Name:BOWDEN, DENISE MAILLOUX (MS, LAC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MAILLOUX
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 SACRAMENTO ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2225
Mailing Address - Country:US
Mailing Address - Phone:415-440-7668
Mailing Address - Fax:
Practice Address - Street 1:2409 SACRAMENTO ST
Practice Address - Street 2:SUITE #2
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2225
Practice Address - Country:US
Practice Address - Phone:415-440-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10915171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist