Active NPI
Bruce Wayne Elowyn Lowe, PH.D.
- Clinical Psychologist
- Fremont, CA
National Provider Identifier
1134318108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 18481
- Practice address
- 4197 Corrigan Dr
Fremont, CA 94536-5904 - Phone
- (510) 797-1046
- NPI assigned
- Oct 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 18481 | CA | Primary |
Addresses
Primary practice location
4197 Corrigan Dr
Fremont, CA 94536-5904
Mailing address
4197 Corrigan Drive
Fremont, CA 94536-5904
Phone (510) 797-1046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 18481 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1134318108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4197 CORRIGAN DRIVE",
"city": "FREMONT",
"state": "CA",
"postal_code": "945365904",
"telephone_number": "510-797-1046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4197 CORRIGAN DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945365904",
"telephone_number": "510-797-1046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOWE",
"first_name": "BRUCE WAYNE",
"middle_name": "ELOWYN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-16",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 18481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.