Provider Demographics
NPI:1124862008
Name:LEWIS, CHEYENNE SUMMER (DC)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:SUMMER
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23520 TOKAYANA WAY
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9591
Mailing Address - Country:US
Mailing Address - Phone:530-863-3956
Mailing Address - Fax:
Practice Address - Street 1:210 PALM AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3906
Practice Address - Country:US
Practice Address - Phone:530-205-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor