MEDICARE: ARASELI P LEWIS PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY25551	CA

General Provider Information

NPI Number	:	1144395542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARASELI P LEWIS PH.D

Provider Business Mailing Address
First Line	:	PO BOX 231345
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92193-1345
Country	:	US
Telephone Number	:	619-248-3072
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 HORNBLEND ST
Second Line	:	21
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-4138
Country	:	US
Telephone Number	:	619-248-3072
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	04/17/2015

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