Provider Demographics
NPI:1912914748
Name:BROWN-BOWLER, ALICE CAMPBELL
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:CAMPBELL
Last Name:BROWN-BOWLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:CAMPBELL
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:41847 55TH STREET WEST
Mailing Address - Street 2:ATTN: GEWL PADILLA, OFFICE MANAGER
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536
Mailing Address - Country:US
Mailing Address - Phone:661-878-3326
Mailing Address - Fax:
Practice Address - Street 1:43535 17TH STREET WEST
Practice Address - Street 2:SUITE 304
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-942-4079
Practice Address - Fax:661-942-3887
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist