Provider Demographics
NPI:1821984311
Name:GILLETTE, LEXIS D
Entity type:Individual
Prefix:
First Name:LEXIS
Middle Name:D
Last Name:GILLETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6483 HUMBOLDT HILL RD
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-7413
Mailing Address - Country:US
Mailing Address - Phone:707-666-5646
Mailing Address - Fax:
Practice Address - Street 1:6483 HUMBOLDT HILL RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-7413
Practice Address - Country:US
Practice Address - Phone:707-666-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program