Provider Demographics
NPI:1477380277
Name:ROWLES, SAMANTHA (AMFT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:ROWLES
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:810 W COMPTON BLVD APT 13
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-2958
Mailing Address - Country:US
Mailing Address - Phone:310-344-0161
Mailing Address - Fax:
Practice Address - Street 1:810 W COMPTON BLVD APT 13
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-2958
Practice Address - Country:US
Practice Address - Phone:310-344-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT110836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist