Healthcare Provider Details

I. General information

NPI: 1700901014
Provider Name (Legal Business Name): DOROTHY MCQUOWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2477 WASHINGTON ST
SAN FRANCISCO CA
94115-1816
US

IV. Provider business mailing address

2477 WASHINGTON ST
SAN FRANCISCO CA
94115-1816
US

V. Phone/Fax

Practice location:
  • Phone: 415-929-7027
  • Fax: 415-383-7469
Mailing address:
  • Phone: 415-929-7027
  • Fax: 415-383-7469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY4955
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: