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General NPI Number Information
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NPI Number | 1013062033
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Entity Type | Organization
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Legal Business Name | SUSAN LEWIS, L.C.S.W.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/14/2012
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 530-306-0625
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1976
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City | FOLSOM
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State | CA
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Zip | 95763-1976
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Country | US
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Telephone | 530-306-0625
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC SOCIAL WORKER
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Name | SUSAN LEWIS
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Credential | L.C.S.W.
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Telephone | 530-306-0625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 14404
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License Number State | CA
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