Provider Demographics
NPI:1851756175
Name:LOWE, WESCINA (PSYD, BCBA)
Entity Type:Individual
Prefix:
First Name:WESCINA
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:PSYD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 W NUEVO RD # 219
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-0801
Mailing Address - Country:US
Mailing Address - Phone:562-256-5862
Mailing Address - Fax:
Practice Address - Street 1:75 W NUEVO RD # 219
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-0801
Practice Address - Country:US
Practice Address - Phone:562-256-5862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-31
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CAPSB94025264103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist