Provider Demographics
NPI:1912914342
Name:OWEN, MICHAEL LOUIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:OWEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3700 DELTA FAIR BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4019
Mailing Address - Country:US
Mailing Address - Phone:925-756-8097
Mailing Address - Fax:925-706-0213
Practice Address - Street 1:3700 DELTA FAIR BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4019
Practice Address - Country:US
Practice Address - Phone:925-756-8097
Practice Address - Fax:925-706-0213
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALCS87841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical