Healthcare Provider Details

I. General information

NPI: 1508774795
Provider Name (Legal Business Name): LUCIA INSINGO LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73925 HIGHWAY 111 STE J
PALM DESERT CA
92260-4029
US

IV. Provider business mailing address

44384 RUSSELL LN
PALM DESERT CA
92260-2925
US

V. Phone/Fax

Practice location:
  • Phone: 760-777-0864
  • Fax:
Mailing address:
  • Phone: 760-777-0864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number63740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: