Provider Demographics
NPI:1851460422
Name:WILCO-OWENS, LOIS RACHEL (MS, MFT)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:RACHEL
Last Name:WILCO-OWENS
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 MARSHA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-4028
Mailing Address - Country:US
Mailing Address - Phone:408-277-0500
Mailing Address - Fax:408-448-1779
Practice Address - Street 1:2461 MARSHA WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-4028
Practice Address - Country:US
Practice Address - Phone:408-277-0500
Practice Address - Fax:408-448-1779
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist