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General NPI Number Information
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NPI Number | 1386948883
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Entity Type | Individual
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Provider Name | STACY LEWIS CBRE
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Gender | Female
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 7254 GABRIEL DR
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City | FONTANA
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State | CA
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Zip | 92336-5761
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Country | US
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Telephone | 909-510-9867
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Fax | 909-823-0640
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Provider Business Mailing Address
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Address Line | 7254 GABRIEL DR
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City | FONTANA
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State | CA
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Zip | 92336-5761
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Country | US
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Telephone | 909-510-9867
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Fax | 909-823-0640
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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