Provider Demographics
NPI:1710023452
Name:JOWERS & TALLEY PSYCHOTHERAPY, A P C
Entity Type:Organization
Organization Name:JOWERS & TALLEY PSYCHOTHERAPY, A P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-482-6006
Mailing Address - Street 1:PO BOX 753
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-0753
Mailing Address - Country:US
Mailing Address - Phone:626-482-6006
Mailing Address - Fax:
Practice Address - Street 1:41870 KALMIA ST STE 155
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8850
Practice Address - Country:US
Practice Address - Phone:626-482-6006
Practice Address - Fax:951-679-8291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALCSW152161041C0700X
CAMFT35109106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA492295OtherVALUE OPTIONS
CA=========OtherTAX ID OR EIN