Provider Demographics
NPI:1629234984
Name:BOWERS-WOODS, BUFFY
Entity Type:Individual
Prefix:
First Name:BUFFY
Middle Name:
Last Name:BOWERS-WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 W LOS ALTOS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3020
Mailing Address - Country:US
Mailing Address - Phone:559-304-3101
Mailing Address - Fax:
Practice Address - Street 1:5617 W LOS ALTOS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-3020
Practice Address - Country:US
Practice Address - Phone:559-304-3101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29469101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health