Provider Demographics
NPI:1811473143
Name:LEWTON, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LEWTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16830 VENTURA BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1707
Mailing Address - Country:US
Mailing Address - Phone:818-986-1203
Mailing Address - Fax:951-272-9924
Practice Address - Street 1:16830 VENTURA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1707
Practice Address - Country:US
Practice Address - Phone:818-986-1203
Practice Address - Fax:951-272-9924
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17687171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC17687OtherCA MEDICAL LICENSE