Healthcare Provider Details

I. General information

NPI: 1972654093
Provider Name (Legal Business Name): THOMAS BARNETT LEWIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 BRIDGEWAY STE 3A
SAUSALITO CA
94965-2193
US

IV. Provider business mailing address

767 BRIDGEWAY STE 3A
SAUSALITO CA
94965-2193
US

V. Phone/Fax

Practice location:
  • Phone: 415-664-6929
  • Fax:
Mailing address:
  • Phone: 415-664-6929
  • Fax: 415-331-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG069558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: