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General NPI Number Information
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NPI Number | 1245676246
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Entity Type | Individual
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Provider Name | LISA MARIE BOWEN L.AC., DIPL.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 268 LOMBARD ST
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8223
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Country | US
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Telephone | 818-317-0010
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Fax | 805-522-4998
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Provider Business Mailing Address
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Address Line | 2911 FLANAGAN DR
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City | SIMI VALLEY
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State | CA
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Zip | 93063-5705
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Country | US
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Telephone | 818-317-0010
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Fax | 805-522-4998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 14202
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License Number State | CA
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