Provider Demographics
NPI:1669043915
Name:BOWEN, SHARON ANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANNE
Last Name:BOWEN
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:PO BOX 3768
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92628-3768
Mailing Address - Country:US
Mailing Address - Phone:949-302-4316
Mailing Address - Fax:
Practice Address - Street 1:3700 S.PLAZA DR
Practice Address - Street 2:BPH02
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704
Practice Address - Country:US
Practice Address - Phone:949-302-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist