MEDICARE: ALFRED RAY ROWLETT 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
1	1041C0700X	Clinical Social Worker	20931	CA

General Provider Information

NPI Number	:	1831291491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED RAY ROWLETT LCSW

Provider Business Mailing Address
First Line	:	10325 SADDLE CREEK DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-6583
Country	:	US
Telephone Number	:	916-682-9746
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 VIKING DR STE 114
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2844
Country	:	US
Telephone Number	:	916-364-8395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	07/08/2007

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