MEDICARE: URSULA 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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1902078793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	URSULA LEWIS

Provider Business Mailing Address
First Line	:	7958 CARMENCITA AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-9444
Country	:	US
Telephone Number	:	253-228-7801
Fax Number	:

Provider Business Practice Location Address
First Line	:	5170 GOLDEN FOOTHILL PKWY # 150
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9608
Country	:	US
Telephone Number	:	253-228-7801
Fax Number	:

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

Provider Enumeration Date	:	04/01/2008
Last Update Date	:	07/29/2014

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Directions to “ URSULA LEWIS ” Practice Location

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