MEDICARE: MS. CARLA A CAVALIER BOWDOIN L.C.S.W.

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	1041C0700X	Clinical Social Worker	26765	CA

General Provider Information

NPI Number	:	1851650170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARLA A CAVALIER BOWDOIN L.C.S.W.

Provider Business Mailing Address
First Line	:	734 SILVER SPUR RD STE 105
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3663
Country	:	US
Telephone Number	:	213-247-0577
Fax Number	:	323-294-3127

Provider Business Practice Location Address
First Line	:	734 SILVER SPUR RD STE 105
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3663
Country	:	US
Telephone Number	:	213-247-0577
Fax Number	:	323-294-3127

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

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	03/18/2013

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