Provider Demographics
NPI:1144193368
Name:BOWEN, CHAD PATRICK (R1615470525)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:PATRICK
Last Name:BOWEN
Suffix:
Gender:M
Credentials:R1615470525
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4380
Mailing Address - Country:US
Mailing Address - Phone:530-745-4061
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:318 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4380
Practice Address - Country:US
Practice Address - Phone:530-745-4061
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1615470525101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)