Healthcare Provider Details

I. General information

NPI: 1871106799
Provider Name (Legal Business Name): ANNABEL BOUWER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2020
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 MURRAY AVE
GILROY CA
95020-3673
US

IV. Provider business mailing address

9015 MURRAY AVE
GILROY CA
95020-3673
US

V. Phone/Fax

Practice location:
  • Phone: 408-842-7138
  • Fax:
Mailing address:
  • Phone: 408-396-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: