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NPI Code Detail

MEDICARE: MRS. JENNIFER LEWIS LCSW

MEDICARE:  MRS. JENNIFER  LEWIS  LCSW
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
11041C0700XClinical Social Worker66851CA

General Provider Information

NPI Number : 1407037468
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LEWIS LCSW
Provider Business Mailing Address
First Line : 6150 CENTER ST UNIT 796
Second Line :
City : CLAYTON
State : CA
Zip : 94517-5045
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1430 WILLOW PASS RD STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-7946
Country : US
Telephone Number : 925-288-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2007
Last Update Date : 04/24/2018

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Directions to “ MRS. JENNIFER LEWIS LCSW” Practice Location

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