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General NPI Number Information
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NPI Number | 1952176042
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Entity Type | Individual
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Provider Name | DEVON BOWEN
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Gender | Female
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 17100 EUCLID ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4043
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Country | US
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Telephone | 714-966-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 770 WESLEYAN BAY
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City | COSTA MESA
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State | CA
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Zip | 92626-2986
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Country | US
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Telephone | 541-550-8731
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2006205
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License Number State | CA
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