Individual
ANISHA NICOLE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 ALABAMA ST, VALLEJO, CA 94590-4446
(707) 515-7186
Mailing address
201 ALAMEDA DEL PRADO STE 103, NOVATO, CA 94949-6698
(415) 457-6964
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
06/12/2017
Last updated
07/17/2023
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