Healthcare Provider Details

I. General information

NPI: 1982919916
Provider Name (Legal Business Name): PHILLIP T LOWE PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PHIL T LOWE PSY.D

II. Dates (important events)

Enumeration Date: 08/14/2010
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N OCCIDENTAL BLVD # 243
LOS ANGELES CA
90026-4641
US

IV. Provider business mailing address

2893 QUEENS WAY
THOUSAND OAKS CA
91362-5347
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-4400
  • Fax:
Mailing address:
  • Phone: 805-413-2151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: