Healthcare Provider Details

I. General information

NPI: 1992651640
Provider Name (Legal Business Name): SOVANN DOWLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 CHESTNUT AVE
LONG BEACH CA
90813-1674
US

IV. Provider business mailing address

455 E SUNSET ST
LONG BEACH CA
90805-6619
US

V. Phone/Fax

Practice location:
  • Phone: 562-599-8444
  • Fax: 562-591-6134
Mailing address:
  • Phone: 562-314-5360
  • Fax: 562-591-6134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number25473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: