Healthcare Provider Details

I. General information

NPI: 1669898367
Provider Name (Legal Business Name): KIRSTEN LOWRY PSYCHOLOGIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 JOHNSON AVE
SAN LUIS OBISPO CA
93401-4131
US

IV. Provider business mailing address

PO BOX 4524
PASO ROBLES CA
93447-4524
US

V. Phone/Fax

Practice location:
  • Phone: 805-602-1062
  • Fax:
Mailing address:
  • Phone: 805-602-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberPSY23890
License Number StateCA

VIII. Authorized Official

Name: DR. KIRSTEN LOWRY
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 805-602-1062