Healthcare Provider Details

I. General information

NPI: 1306241427
Provider Name (Legal Business Name): SHERRY LEW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2014
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 POST ST
SAN FRANCISCO CA
94109-5603
US

IV. Provider business mailing address

1234 INDIANA ST
SAN FRANCISCO CA
94107-3406
US

V. Phone/Fax

Practice location:
  • Phone: 415-775-1345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: