Provider Demographics
NPI:1508933508
Name:ROWAN, KAYE-AILSA F (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KAYE-AILSA
Middle Name:F
Last Name:ROWAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 MOORPARK AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1804
Mailing Address - Country:US
Mailing Address - Phone:408-390-3680
Mailing Address - Fax:408-503-6853
Practice Address - Street 1:4010 MOORPARK AVE STE 118
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1804
Practice Address - Country:US
Practice Address - Phone:408-390-3680
Practice Address - Fax:408-503-6853
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT47779106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41824OtherSANTA CLARA COUNTY ID