Basic Information
| Provider Information | |||||||||
| NPI: | 1184832644 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWDEN | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1244 | ||||||||
| Address2: | |||||||||
| City: | FERNDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955361244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077864434 | ||||||||
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| Practice Location | |||||||||
| Address1: | ST. JOSEPH HOSPITAL | ||||||||
| Address2: | 2700 DOLBEER ST | ||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074458121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 744 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.