Healthcare Provider Details

I. General information

NPI: 1427197540
Provider Name (Legal Business Name): TRAVIS H OWENS PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1891 E ROSEVILLE PKWY STE 100
ROSEVILLE CA
95661-7974
US

IV. Provider business mailing address

1891 E ROSEVILLE PKWY STE 100
ROSEVILLE CA
95661-7974
US

V. Phone/Fax

Practice location:
  • Phone: 916-789-7083
  • Fax: 916-797-8840
Mailing address:
  • Phone: 916-789-7083
  • Fax: 916-797-8840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY8303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: