Provider Demographics
NPI:1215227434
Name:LEWIS, SHERRON K (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHERRON
Middle Name:K
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 W. KANAI AVE.
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-1732
Mailing Address - Country:US
Mailing Address - Phone:559-283-6605
Mailing Address - Fax:559-793-1189
Practice Address - Street 1:1055 W MORTON AVE
Practice Address - Street 2:SUITE F
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-1974
Practice Address - Country:US
Practice Address - Phone:559-283-6605
Practice Address - Fax:559-793-1189
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 53535106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist