Provider Demographics
NPI:1851615801
Name:LEWIS, LILLIAN Y
Entity type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:Y
Last Name:LEWIS
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 1:3307 BROADWAY
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2821
Mailing Address - Country:US
Mailing Address - Phone:916-454-4242
Mailing Address - Fax:916-454-2960
Practice Address - Street 1:3307 BROADWAY
Practice Address - Street 2:SUITE # 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2821
Practice Address - Country:US
Practice Address - Phone:916-454-4242
Practice Address - Fax:916-454-2960
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)