Provider Demographics
NPI:1134130313
Name:LEW, FELICIA JOLIE (OD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:JOLIE
Last Name:LEW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3088 TELEGRAPH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3234
Mailing Address - Country:US
Mailing Address - Phone:805-648-6891
Mailing Address - Fax:
Practice Address - Street 1:3088 TELEGRAPH RD
Practice Address - Street 2:SUITE A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3234
Practice Address - Country:US
Practice Address - Phone:805-648-6891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist