Healthcare Provider Details

I. General information

NPI: 1427913144
Provider Name (Legal Business Name): CASSANDRA LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3789 HOOVER ST
REDWOOD CITY CA
94063-4504
US

IV. Provider business mailing address

3789 HOOVER ST
REDWOOD CITY CA
94063-4504
US

V. Phone/Fax

Practice location:
  • Phone: 650-363-8735
  • Fax:
Mailing address:
  • Phone: 650-363-8735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: