Provider Demographics
NPI:1558160341
Name:BOWLING, PAULETTE SUZANNE
Entity type:Individual
Prefix:
First Name:PAULETTE
Middle Name:SUZANNE
Last Name:BOWLING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 CORONADO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-1561
Mailing Address - Country:US
Mailing Address - Phone:562-987-5722
Mailing Address - Fax:
Practice Address - Street 1:3125 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-4932
Practice Address - Country:US
Practice Address - Phone:562-987-5722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)