Healthcare Provider Details

I. General information

NPI: 1962332387
Provider Name (Legal Business Name): MARIA FOWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23231 FAISAN COURT
VALENCIA CA
91355
US

IV. Provider business mailing address

23231 FAISAN CT
VALENCIA CA
91355-2212
US

V. Phone/Fax

Practice location:
  • Phone: 661-289-0498
  • Fax:
Mailing address:
  • Phone: 661-289-0598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberW2043649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: