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NPI Code Detail

MEDICARE: JESSICA STEPHANIE VERANIQUE LEWIS B.A.

MEDICARE: JESSICA STEPHANIE VERANIQUE LEWIS B.A.
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
1373H00000XDay Training/Habilitation SpecialistCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205771250
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA STEPHANIE VERANIQUE LEWIS B.A.
Provider Business Mailing Address
First Line : 3601 CALLE TECATE STE 201
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5290
Country : US
Telephone Number : 805-289-0120
Fax Number : 805-289-0120
Provider Business Practice Location Address
First Line : 3601 CALLE TECATE STE 201
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5290
Country : US
Telephone Number : 805-289-0120
Fax Number : 805-289-0120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2026
Last Update Date : 06/30/2026

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