Individual
ANTHONY LEWIS MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT 135958
Contact information
Practice address
205 PASADENA AVE, SOUTH PASADENA, CA 91030-2919
(323) 344-5536
Mailing address
1515 HOPE ST STE 204, SOUTH PASADENA, CA 91030-2610
(323) 633-9433
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
135958
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7184
MEDI-CAL
CA
01
—
7368
MEDI-CAL
CA
01
—
7667
MEDI-CAL
CA
01
—
7708
MEDI-CAL
CA
Enumeration date
03/06/2007
Last updated
01/20/2023
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