MEDICARE: DEMERIEL RACHEL LEWIS

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	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1316639461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEMERIEL RACHEL LEWIS

Provider Business Mailing Address
First Line	:	9340 E STOCKTON BLVD
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1563
Country	:	US
Telephone Number	:	916-509-8199
Fax Number	:

Provider Business Practice Location Address
First Line	:	9340 E STOCKTON BLVD
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1558
Country	:	US
Telephone Number	:	916-509-8199
Fax Number	:

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

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	04/23/2026

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Directions to “ DEMERIEL RACHEL LEWIS ” Practice Location

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