Provider Demographics
NPI:1144241266
Name:LEHMAN, STACY BREA (CMT)
Entity Type:Individual
Prefix:MISS
First Name:STACY
Middle Name:BREA
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6256 GENEVA ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6615
Mailing Address - Country:US
Mailing Address - Phone:805-660-1593
Mailing Address - Fax:805-495-1390
Practice Address - Street 1:128 AUBURN CT
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3619
Practice Address - Country:US
Practice Address - Phone:805-495-0110
Practice Address - Fax:805-495-1390
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73545174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist