Provider Demographics
NPI:1790816411
Name:COWAN, LONNI (LMFT ATR BC)
Entity Type:Individual
Prefix:MS
First Name:LONNI
Middle Name:
Last Name:COWAN
Suffix:
Gender:F
Credentials:LMFT ATR BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 STRONGS DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-4428
Mailing Address - Country:US
Mailing Address - Phone:310-823-3575
Mailing Address - Fax:
Practice Address - Street 1:370 CRENSHAW BLVD
Practice Address - Street 2:SUITE E 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1727
Practice Address - Country:US
Practice Address - Phone:310-787-1500
Practice Address - Fax:310-787-9713
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41264106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist