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NPI 1497902621

NPI 1497902621 : ANDREW MCGOWAN : CAMARILLO, CA

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General NPI Number Information
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    NPI Number           |    1497902621
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW MCGOWAN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/19/2008
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    Last Update Date     |    03/22/2013
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Provider Practice Location Address
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    Address Line         |    1722 S LEWIS RD CAMARILLO
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    City                 |    CAMARILLO
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    State                |    CA
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    Zip                  |    93012-8520
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    Country              |    US
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    Telephone            |    805-419-2338
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    324 E CARILLO ST 
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    City                 |    SANTA BARBARA
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    State                |    CA
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    Zip                  |    93101
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    Country              |    US
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    Telephone            |    805-419-2338
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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       |    MFC 50528
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    License Number State |    CA
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