Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CCADCRS6894 | CA |
NPI | 1003058843 |
---|---|
Provider Name | Ms. Angela Rochelle Stowers |
First Address | Pittsburg, CA 94565-3701 |
Second Address | Pittsburg, CA 94565-3701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2009 |
Last Update Date | 25/03/2009 |