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General NPI Number Information
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NPI Number | 1366826950
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Entity Type | Individual
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Provider Name | NATALIE GOWERN
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Gender | Female
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 601 E IMPERIAL HWY
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City | LA HABRA
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State | CA
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Zip | 90631-7463
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Country | US
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Telephone | 714-644-6480
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 381
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City | FULLERTON
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State | CA
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Zip | 92836-0381
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Country | US
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Telephone | 714-566-4426
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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