Provider Demographics
NPI:1548405947
Name:MCKOWEN, CHRISTOPHER BRIAN (MA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:MCKOWEN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 EL CAMINO REAL
Mailing Address - Street 2:#325
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-3314
Mailing Address - Country:US
Mailing Address - Phone:650-796-3977
Mailing Address - Fax:
Practice Address - Street 1:480 MANOR PLZ
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-1839
Practice Address - Country:US
Practice Address - Phone:650-355-8787
Practice Address - Fax:650-355-8780
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-14
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health