Individual
EBONY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3609 10TH AVE, LOS ANGELES, CA 90018-4114
(323) 298-3680
(213) 402-3551
Mailing address
3609 10TH AVE, LOS ANGELES, CA 90018-4114
(323) 298-3680
(213) 402-3551
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
MPSS-ZSPFMN
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
04/16/2025
Last updated
09/12/2025
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