Provider Demographics
NPI:1427134733
Name:LEW, WEI MON (PHD)
Entity type:Individual
Prefix:DR
First Name:WEI
Middle Name:MON
Last Name:LEW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2401
Mailing Address - Country:US
Mailing Address - Phone:650-573-9765
Mailing Address - Fax:415-433-0953
Practice Address - Street 1:421 27TH AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2401
Practice Address - Country:US
Practice Address - Phone:650-573-9765
Practice Address - Fax:415-433-0953
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4074103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical