Provider Demographics
NPI:1225038227
Name:LEWIS, ZENDA YVETTE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ZENDA
Middle Name:YVETTE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22664 SPRINGMIST DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-2698
Mailing Address - Country:US
Mailing Address - Phone:951-601-0168
Mailing Address - Fax:
Practice Address - Street 1:880 N STATE ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-1459
Practice Address - Country:US
Practice Address - Phone:951-766-2450
Practice Address - Fax:951-766-2479
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14836363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical