Provider Demographics
NPI:1841013950
Name:BOWENS, OMARI Z
Entity type:Individual
Prefix:
First Name:OMARI
Middle Name:Z
Last Name:BOWENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2432
Mailing Address - Country:US
Mailing Address - Phone:323-218-9774
Mailing Address - Fax:
Practice Address - Street 1:879 W 190TH ST STE 1000
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4255
Practice Address - Country:US
Practice Address - Phone:310-768-0088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician