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NPI Code Detail

MEDICARE: MRS. O'SHONDA RENEE MCDOWELL MSW, LCSW

MEDICARE: MRS. O'SHONDA RENEE MCDOWELL MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorASW63033CA
21041C0700XClinical Social WorkerLCSW87302CA

General Provider Information

NPI Number : 1407294515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. O'SHONDA RENEE MCDOWELL MSW, LCSW
Provider Business Mailing Address
First Line : 1950 S SUNWEST LN
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-3258
Country : US
Telephone Number : 951-259-6384
Fax Number :
Provider Business Practice Location Address
First Line : 16756 CHINO CORONA RD
Second Line :
City : EASTVALE
State : CA
Zip : 92880-9508
Country : US
Telephone Number : 626-346-8354
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2013
Last Update Date : 12/27/2022

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