Provider Demographics
NPI:1386948883
Name:LEWIS, STACY (CBRE)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CBRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7254 GABRIEL DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5761
Mailing Address - Country:US
Mailing Address - Phone:909-510-9867
Mailing Address - Fax:909-823-0640
Practice Address - Street 1:7254 GABRIEL DR
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-5761
Practice Address - Country:US
Practice Address - Phone:909-510-9867
Practice Address - Fax:909-823-0640
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator