Provider Demographics
NPI:1306382858
Name:LEWIS, SHALEAH ALANIA (MS,CRC)
Entity Type:Individual
Prefix:
First Name:SHALEAH
Middle Name:ALANIA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS,CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 MORENA BLVD
Mailing Address - Street 2:STE. 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3889
Mailing Address - Country:US
Mailing Address - Phone:619-248-6593
Mailing Address - Fax:
Practice Address - Street 1:1260 MORENA BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3889
Practice Address - Country:US
Practice Address - Phone:619-398-0355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health