Provider Demographics
NPI:1417284092
Name:LEWETZON, CLAUDIA J (MSPT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:J
Last Name:LEWETZON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 LAUREL ST # 1181
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3914
Mailing Address - Country:US
Mailing Address - Phone:650-868-3674
Mailing Address - Fax:650-593-7732
Practice Address - Street 1:809 LAUREL ST # 1181
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3914
Practice Address - Country:US
Practice Address - Phone:650-868-3674
Practice Address - Fax:650-593-7732
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT200812251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics