Provider Demographics
NPI:1124676275
Name:JOWER, ANASI (PPS)
Entity type:Individual
Prefix:MS
First Name:ANASI
Middle Name:
Last Name:JOWER
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 JACARANDA ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-6355
Mailing Address - Country:US
Mailing Address - Phone:925-550-4741
Mailing Address - Fax:
Practice Address - Street 1:140 BIRCH ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1646
Practice Address - Country:US
Practice Address - Phone:925-513-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool