Basic Information
| Provider Information | |||||||||
| NPI: | 1609261692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROWELL | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5417 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958413164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163883231 | ||||||||
| FaxNumber: | 9163883232 | ||||||||
| Practice Location | |||||||||
| Address1: | 6117 RUTLAND DR | ||||||||
| Address2: | |||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956080718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166092420 | ||||||||
| FaxNumber: | 9169629814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2015 | ||||||||
| LastUpdateDate: | 12/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 83603 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.