Provider Demographics
NPI:1144395542
Name:LEWIS, ARASELI P (PHD)
Entity Type:Individual
Prefix:
First Name:ARASELI
Middle Name:P
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 231345
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-1345
Mailing Address - Country:US
Mailing Address - Phone:619-248-3072
Mailing Address - Fax:
Practice Address - Street 1:1111 HORNBLEND ST
Practice Address - Street 2:21
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4138
Practice Address - Country:US
Practice Address - Phone:619-248-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25551103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist