Active NPI
Brock L. Fowler, PSY.D.
- Clinical Psychologist
- Glendale, CA
National Provider Identifier
1841408127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20528
- Practice address
- 1560 E Chevy Chase Dr Ste 130
Glendale, CA 91206-4140 - Phone
- (336) 327-1496
- Fax
- (415) 296-5299
- NPI assigned
- May 18, 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 | 20528 | CA | Primary |
Addresses
Primary practice location
1560 E Chevy Chase Dr Ste 130
Glendale, CA 91206-4140
Mailing address
3308 Winchester Dr
Greensboro, NC 27406-5836
Phone (336) 327-1496
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20528 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matrix Behavioral Health, Inc | Clinical | Past | Accepting new patients |
| Synchrony of Visalia, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Visalia, CA
- NPI 1316676737
-
- Psychologist
- Visalia, CA
- NPI 1457470825
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1841408127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3308 WINCHESTER DR",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274065836",
"telephone_number": "336-327-1496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 E CHEVY CHASE DR STE 130",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064140",
"telephone_number": "336-327-1496",
"fax_number": "415-296-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "BROCK",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "20528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.