Healthcare Provider Details

I. General information

NPI: 1225911662
Provider Name (Legal Business Name): MR. LEWIS JAVON FRENCH II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 W ALMA AVE
SAN JOSE CA
95110-3631
US

IV. Provider business mailing address

2001 GATEWAY PL STE 230E
SAN JOSE CA
95110-3719
US

V. Phone/Fax

Practice location:
  • Phone: 408-931-6838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: