=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164539151
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN P LOWNSBERY MFT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2101 ALEXIAN DR STE 110
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-272-6518
-----------------------------------------------------
Fax | 408-272-6569
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1199 DEAN AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95125-3302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-595-9451
-----------------------------------------------------
Fax | 408-691-7804
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFT 31363
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------