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General NPI Number Information
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NPI Number | 1902969124
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Entity Type | Individual
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Provider Name | CHARMAINE GRACE LOWE PHD
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 10/28/2018
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Provider Practice Location Address
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Address Line | 1240 SAN ELIJO RD N
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City | SAN MARCOS
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State | CA
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Zip | 92078-1086
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Country | US
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Telephone | 626-644-0376
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 SAN ELIJO ROAD NORTH
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City | SAN MARCOS
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State | CA
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Zip | 92078-1086
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Country | US
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Telephone | 760-304-4168
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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