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NPI Code Detail

MEDICARE: JESSICA LEWIS

MEDICARE: JESSICA 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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1881520245
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LEWIS
Provider Business Mailing Address
First Line : 111 DEERWOOD RD STE 115
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-4445
Country : US
Telephone Number : 949-326-4402
Fax Number :
Provider Business Practice Location Address
First Line : 111 DEERWOOD RD STE 115
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-4445
Country : US
Telephone Number : 949-326-4402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/22/2026

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Directions to “ JESSICA LEWIS ” Practice Location

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