Tristan Bowman
Individual provider Active NPI Professional Counselor · Modesto, CA
NPI 1669987301 · NPPES record last updated Sep 15, 2025
Key facts
- NPI
- 1669987301
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- AMFT153949 (CA)
- Practice address
- 2000 W Briggsmore Ave
Modesto, CA 95350-3839 - Phone
- (209) 526-1476
- NPI assigned
- Dec 4, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT153949 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Human Services | Current |
Accepting new patients |
Locations
2000 W Briggsmore Ave
Modesto, CA 95350
Phone (209) 526-1440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | AMFT153949 | CA | Yes |
Addresses
Primary practice location
2000 W Briggsmore Ave
Modesto, CA 95350-3839
Mailing address
2000 W Briggsmore Ave
Modesto, CA 95350-3839
Phone (209) 526-1476
Other providers in Modesto, CA
- Courtney Marie Bowers
- Michael Bowlin
- Diane Sue Bowman
- Ericka Bowman I
- Robert Bowman
- Johnny Bowrey
- Madison Boyatt
- Allison Loutanda Boyd
- Ashley Boyd
- James Michael Boyd
All providers in Modesto, CA · Professional Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.