Individual
MS. LISA RAE BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT, NBC-HWC
Contact information
Practice address
454 LAS GALLINAS AVE # 2023, SAN RAFAEL, CA 94903-3618
(415) 454-3400
Mailing address
454 LAS GALLINAS AVE # 2023, SAN RAFAEL, CA 94903-3618
(415) 454-3400
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
NBHWCA3622179
CA
174H00000X
Health Educator
—
—
225700000X
Massage Therapist
CAMTC 32577
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222672
WELLCOACHES
—
01
—
32577
CAMTC
CA
01
—
A-3622179
NBHWC
—
Enumeration date
12/02/2014
Last updated
12/26/2025
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