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NPI Code Detail

MEDICARE: ROWAN E FOLEY LEP

MEDICARE:   ROWAN E FOLEY  LEP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist4295CA

General Provider Information

NPI Number : 1225713845
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROWAN E FOLEY LEP
Provider Business Mailing Address
First Line : 2564 REGIS DR
Second Line :
City : DAVIS
State : CA
Zip : 95618-1557
Country : US
Telephone Number : 530-219-4309
Fax Number :
Provider Business Practice Location Address
First Line : 1260 LAKE BLVD
Second Line : WL-228
City : DAVIS
State : CA
Zip : 95616-2614
Country : US
Telephone Number : 530-219-4309
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2023
Last Update Date : 02/16/2024

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Directions to “ ROWAN E FOLEY LEP” Practice Location

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