Healthcare Provider Details

I. General information

NPI: 1477576130
Provider Name (Legal Business Name): ROBIN LYNNE BOWMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 BRESLAUER WAY
REDDING CA
96001-4246
US

IV. Provider business mailing address

855 CANYON RD
REDDING CA
96001-5544
US

V. Phone/Fax

Practice location:
  • Phone: 530-227-4453
  • Fax: 530-225-2577
Mailing address:
  • Phone: 530-378-1855
  • Fax: 530-378-0857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: