Healthcare Provider Details

I. General information

NPI: 1154230712
Provider Name (Legal Business Name): KELSEY C FOWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8060 DORIAN WAY
FAIR OAKS CA
95628-5015
US

IV. Provider business mailing address

8060 DORIAN WAY
FAIR OAKS CA
95628-5015
US

V. Phone/Fax

Practice location:
  • Phone: 916-534-4273
  • Fax:
Mailing address:
  • Phone: 916-534-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number14692KF
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: