Healthcare Provider Details

I. General information

NPI: 1477401024
Provider Name (Legal Business Name): MR. MICHAEL FRANCIS JAMES COWEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N RAYMOND AVE STE 330
PASADENA CA
91103-3947
US

IV. Provider business mailing address

65 N RAYMOND AVE STE 330
PASADENA CA
91103-3947
US

V. Phone/Fax

Practice location:
  • Phone: 323-391-8424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: