Provider Demographics
NPI:1407934375
Name:BOWMAN, SEPTEMBER DIANE (PA, FNP)
Entity Type:Individual
Prefix:MS
First Name:SEPTEMBER
Middle Name:DIANE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PA, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 STATE ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2429
Mailing Address - Country:US
Mailing Address - Phone:805-617-7858
Mailing Address - Fax:805-898-2002
Practice Address - Street 1:1900 STATE ST
Practice Address - Street 2:SUITE G
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2429
Practice Address - Country:US
Practice Address - Phone:805-617-7858
Practice Address - Fax:805-898-2002
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP9650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA14572OtherPA LICENSE
CAP68635Medicare UPIN
CAWNP9650AMedicare ID - Type UnspecifiedMEDICAREPIN