Provider Demographics
NPI:1376912881
Name:JANET BOWDEN, A FAMILY THERAPY CORPRATION
Entity Type:Organization
Organization Name:JANET BOWDEN, A FAMILY THERAPY CORPRATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:310-559-5874
Mailing Address - Street 1:4311 VINTON AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3452
Mailing Address - Country:US
Mailing Address - Phone:310-559-5874
Mailing Address - Fax:
Practice Address - Street 1:4311 VINTON AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3452
Practice Address - Country:US
Practice Address - Phone:310-559-5874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty