Provider Demographics
NPI:1720398829
Name:BOWDEN-SIERRA, DEBRA RENEE (RN, MFT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:RENEE
Last Name:BOWDEN-SIERRA
Suffix:
Gender:F
Credentials:RN, MFT
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:RENEE
Other - Last Name:BOWDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2550 HONOLULU AVE
Mailing Address - Street 2:SUITE # 203
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1858
Mailing Address - Country:US
Mailing Address - Phone:626-483-5304
Mailing Address - Fax:
Practice Address - Street 1:2550 HONOLULU AVE
Practice Address - Street 2:SUITE # 203
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1858
Practice Address - Country:US
Practice Address - Phone:626-483-5304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional