Provider Demographics
NPI:1477577609
Name:BOWMAN, ANDREA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 MANGROVE AVE # 396
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2648
Mailing Address - Country:US
Mailing Address - Phone:530-893-4807
Mailing Address - Fax:
Practice Address - Street 1:1692 MANGROVE AVE # 396
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2648
Practice Address - Country:US
Practice Address - Phone:530-893-4807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 37142106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1477577609Medicaid