MEDICARE: JULIENNE J. LEW NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95022869	CA
2	363LP0200X	Pediatric Nurse Practitioner	382109	NY

General Provider Information

NPI Number	:	1083938161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIENNE J. LEW NP

Provider Business Mailing Address
First Line	:	1295 E HILLSDALE BLVD
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1214
Country	:	US
Telephone Number	:	650-574-2774
Fax Number	:

Provider Business Practice Location Address
First Line	:	1295 E HILLSDALE BLVD
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1214
Country	:	US
Telephone Number	:	650-574-2774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	10/11/2024

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