Provider Demographics
NPI:1205866159
Name:LOWE, LOLAND (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOLAND
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 LA CRESTA AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1726
Mailing Address - Country:US
Mailing Address - Phone:510-206-6029
Mailing Address - Fax:510-482-5964
Practice Address - Street 1:350 30TH ST
Practice Address - Street 2:SUITE 550
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3424
Practice Address - Country:US
Practice Address - Phone:510-206-6029
Practice Address - Fax:510-482-5964
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC16977106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist