Provider Demographics
NPI:1568855187
Name:LEWIS, CRISTI (LM, CPM, CHOM)
Entity Type:Individual
Prefix:
First Name:CRISTI
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LM, CPM, CHOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 GREEN CANYON RD
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-4615
Mailing Address - Country:US
Mailing Address - Phone:760-877-9939
Mailing Address - Fax:
Practice Address - Street 1:577 E ELDER ST
Practice Address - Street 2:SUITE E
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-877-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175L00000X
CALM429176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175L00000XOther Service ProvidersHomeopath