Provider Demographics
NPI:1639899909
Name:MEZGER, ELIZABETH LEWIS
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEWIS
Last Name:MEZGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LEE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3810 ROSIN CT STE 170
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1658
Mailing Address - Country:US
Mailing Address - Phone:916-567-4222
Mailing Address - Fax:916-567-4220
Practice Address - Street 1:2335 AMERICAN RIVER DR STE 301
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7088
Practice Address - Country:US
Practice Address - Phone:925-623-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program