MEDICARE: CLARE LEWIS PT

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	103TC0700X	Clinical Psychologist	PSY24309	CA
2	225100000X	Physical Therapist	PT10647	CA

General Provider Information

NPI Number	:	1902017106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARE LEWIS PT

Provider Business Mailing Address
First Line	:	3127 SPINNING ROD WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-9625
Country	:	US
Telephone Number	:	916-359-3127
Fax Number	:

Provider Business Practice Location Address
First Line	:	2945 BELL ROAD
Second Line	:	# 215
City	:	AUBURN
State	:	CA
Zip	:	95603
Country	:	US
Telephone Number	:	916-367-1888
Fax Number	:	530-888-0885

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

Provider Enumeration Date	:	05/28/2007
Last Update Date	:	10/05/2020

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Directions to “ CLARE LEWIS PT” Practice Location

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