Provider Demographics
NPI:1124367685
Name:HEWES, ELIZABETH ANN
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:HEWES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:HEWES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7286 ROCK CANYON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-1058
Mailing Address - Country:US
Mailing Address - Phone:858-549-8915
Mailing Address - Fax:
Practice Address - Street 1:3990 OLD TOWN AVE
Practice Address - Street 2:C107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2930
Practice Address - Country:US
Practice Address - Phone:619-688-1804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health