Individual
DR. CLIFFORD LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
555 UNIVERSITY AVE STE 235, SACRAMENTO, CA 95825-6505
(916) 978-0522
Mailing address
555 UNIVERSITY AVENUE, SUITE 235, SACRAMENTO, CA 95825-6505
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY6723
CA
103TC0700X
Clinical Psychologist
Primary
PSY6723
CA
103TC1900X
Counseling Psychologist
PSY6723
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680014899
RAILROAD MEDICARE
CA
05
—
PSY067230
—
CA
Enumeration date
11/15/2005
Last updated
04/23/2012
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