Provider Demographics
NPI:1477071983
Name:COWART, MEGAN (HEALTH COACH)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:COWART
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4846 CRESTVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2890 GATEWAY OAKS DR STE 250
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-4328
Practice Address - Country:US
Practice Address - Phone:855-421-6831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAW48829174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty