Basic Information
| Provider Information | |||||||||
| NPI: | 1346637261 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWMAN | ||||||||
| FirstName: | WHITNEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17941 DEVONSHIRE ST | ||||||||
| Address2: | #22 | ||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913251252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189224742 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22110 ROSCOE BLVD | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | CANOGA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913043845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187138700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2015 | ||||||||
| LastUpdateDate: | 04/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 5759-R | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.