Provider Demographics
NPI:1558905174
Name:BOWDEN, ALEXAH CHRISTINE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ALEXAH
Middle Name:CHRISTINE
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 E GARVEY AVE N STE B2
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1509
Mailing Address - Country:US
Mailing Address - Phone:626-489-9144
Mailing Address - Fax:
Practice Address - Street 1:2155 E GARVEY AVE N STE B2
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1509
Practice Address - Country:US
Practice Address - Phone:626-489-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130995106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA116912OtherMEDICAL
CA7065OtherMEDICAL