MEDICARE: MRS. SHARON RACHELLE LEWIS

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	235Z00000X	Speech-Language Pathologist	13094	CA

General Provider Information

NPI Number	:	1447582531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON RACHELLE LEWIS

Provider Business Mailing Address
First Line	:	2443 AZEVEDO PKWY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-6653
Country	:	US
Telephone Number	:	650-274-5746
Fax Number	:

Provider Business Practice Location Address
First Line	:	2443 AZEVEDO PKWY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-6653
Country	:	US
Telephone Number	:	650-274-5746
Fax Number	:

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

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	02/01/2010

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Directions to “ MRS. SHARON RACHELLE LEWIS ” Practice Location

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