Individual
TRACI RENEE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E OCEAN AVE, LOMPOC, CA 93436-6828
(805) 737-7727
Mailing address
5304 TRACI DR, SANTA BARBARA, CA 93111-1457
(805) 407-1649
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ZWGKDL
CA
Other
Enumeration date
02/15/2023
Last updated
07/06/2023
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