THEODORE WILLIAM FOWLER
NPI 1487162962
Counselor - Addiction (Substance Use Disorder) in San Jose, CA
Active since January 18, 2018
About Theodore William Fowler NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THEODORE WILLIAM FOWLER (NPI 1487162962) is an individual addiction (substance use disorder) provider in San Jose, California, licensed in California (R1208500715) and active in the NPI registry since January 2018.
NPPES Registry Identity
NPI1487162962
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameTHEODORE WILLIAM FOWLER
Location Address650 S BASCOM AVESan Jose, CA 95128-2601
Mailing Address650 S Bascom AveSan Jose, CA 95128-2601 · (408) 283-8555
Phone(408) 283-8555
Sole ProprietorYes
Enumeration DateJanuary 18, 2018
✔ NPI 1487162962 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1208500715
650 S BASCOM AVE, San Jose, CA 95128
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
650 S BASCOM AVE
SAN JOSE, CA 95128
SAN JOSE, CA 95128
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487162962, enumerated as an "individual" on January 18, 2018.
The provider is located at 650 S BASCOM AVE SAN JOSE, CA 95128 and the phone number is (408) 283-8555.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
