Provider Demographics
NPI:1730427808
Name:BOWER, DAWN CARLA (IBCLC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:CARLA
Last Name:BOWER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42708 35TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-4107
Mailing Address - Country:US
Mailing Address - Phone:661-916-1290
Mailing Address - Fax:
Practice Address - Street 1:1028 W AVENUE L12 STE 103
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7089
Practice Address - Country:US
Practice Address - Phone:661-916-1290
Practice Address - Fax:661-249-6355
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
CA144499174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty