Individual
JESSICA STEPHANIE VERANIQUE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
612 SPRING RD STE 201, MOORPARK, CA 93021-1482
(805) 289-0120
Mailing address
612 SPRING RD STE 201, MOORPARK, CA 93021-1482
(805) 289-0120
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56CC
—
CA
Enumeration date
04/23/2026
Last updated
04/23/2026
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