Provider Demographics
NPI:1982013108
Name:LOWRY, CAITLIN (MS, IMF, PPS)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MS, IMF, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3639 ARGYLE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-5828
Mailing Address - Country:US
Mailing Address - Phone:559-679-7085
Mailing Address - Fax:
Practice Address - Street 1:1470 W HERNDON AVE STE 300
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-0552
Practice Address - Country:US
Practice Address - Phone:559-256-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALMFT103657OtherLICENSED MARRIAGE AND FAMILY THERAPIST
CAIMF74650OtherMARRIAGE AND FAMILY THERAPY INTERN