MEDICARE: MRS. DEBRA RENEE BOWDEN-SIERRA R.N., M.F.T.

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
1	101YP2500X	Professional Counselor	MFC39555	CA

General Provider Information

NPI Number	:	1720398829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA RENEE BOWDEN-SIERRA R.N., M.F.T.

Provider Business Mailing Address
First Line	:	2550 HONOLULU AVE
Second Line	:	SUITE # 203
City	:	MONTROSE
State	:	CA
Zip	:	91020-1858
Country	:	US
Telephone Number	:	626-483-5304
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 HONOLULU AVE
Second Line	:	SUITE # 203
City	:	MONTROSE
State	:	CA
Zip	:	91020-1858
Country	:	US
Telephone Number	:	626-483-5304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2010
Last Update Date	:	10/07/2010

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