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Organization
USC-TELEHEALTH
Active
Organization
USC-TELEHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL BOWEN (CLINICAL PSYCHOTHERAPIST, INTERN)
(310) 256-6488
Entity
Organization
Contact information
Practice address
3375 S HOOVER ST, SUITE H201, LOS ANGELES, CA 90089-0116
(213) 821-5930
Mailing address
17202 INGLEWOOD AVE, UNIT 122, LAWNDALE, CA 90260-3139
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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