Healthcare Provider Details

I. General information

NPI: 1225515513
Provider Name (Legal Business Name): CYNTHIA ELIZABETH LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR
OXNARD CA
93036-2612
US

IV. Provider business mailing address

1911 WILLIAMS DR
OXNARD CA
93036-2612
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-4233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberPT24953
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: