Provider Demographics
NPI:1144745324
Name:LOWE, ANGELYNA MARI (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGELYNA
Middle Name:MARI
Last Name:LOWE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 CAMINO DEL RIO S STE 212
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4016
Mailing Address - Country:US
Mailing Address - Phone:619-614-3005
Mailing Address - Fax:
Practice Address - Street 1:3505 CAMINO DEL RIO S STE 212
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4016
Practice Address - Country:US
Practice Address - Phone:619-614-3005
Practice Address - Fax:619-329-4412
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29269103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth