Provider Demographics
NPI:1851881791
Name:MEGAN B. LEWIS, PSY.D., A CALIFORNIA PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:MEGAN B. LEWIS, PSY.D., A CALIFORNIA PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:760-707-6765
Mailing Address - Street 1:960 W SAN MARCOS BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-1148
Mailing Address - Country:US
Mailing Address - Phone:760-707-6765
Mailing Address - Fax:760-683-5041
Practice Address - Street 1:960 W SAN MARCOS BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1148
Practice Address - Country:US
Practice Address - Phone:760-707-6765
Practice Address - Fax:760-683-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18875261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)