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General NPI Number Information
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NPI Number | 1245342427
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Entity Type | Individual
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Provider Name | WENDY ANN LEWIS MFT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2100 N SEPULVEDA BLVD STE 30
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2948
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Country | US
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Telephone | 310-322-9889
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Fax | 310-726-1111
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Provider Business Mailing Address
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Address Line | 2100 N SEPULVEDA BLVD STE 30
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2948
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Country | US
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Telephone | 310-322-9889
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Fax | 310-726-1111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT33145
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License Number State | CA
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