Provider Demographics
NPI:1225157019
Name:NOWAKOWSKA, AGATA ELIZABETH (MFT)
Entity Type:Individual
Prefix:MS
First Name:AGATA
Middle Name:ELIZABETH
Last Name:NOWAKOWSKA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2154 RANCH VIEW TER
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6534
Mailing Address - Country:US
Mailing Address - Phone:760-484-1853
Mailing Address - Fax:
Practice Address - Street 1:767 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2031
Practice Address - Country:US
Practice Address - Phone:760-484-1853
Practice Address - Fax:858-793-4406
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53983106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist