Provider Demographics
NPI:1548529258
Name:DOCUYANAN, ROWENA
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:
Last Name:DOCUYANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20101 HAMILTON AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1314
Mailing Address - Country:US
Mailing Address - Phone:213-925-4284
Mailing Address - Fax:
Practice Address - Street 1:20101 HAMILTON AVE STE 155
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1314
Practice Address - Country:US
Practice Address - Phone:213-925-4284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW28536104100000X
CAASW 24092104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker