Provider Demographics
NPI:1881085041
Name:LEWIS-NUNEZ, PAMELA G (LMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:G
Last Name:LEWIS-NUNEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16714 KORNBLUM AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1216
Mailing Address - Country:US
Mailing Address - Phone:310-567-5707
Mailing Address - Fax:
Practice Address - Street 1:16714 KORNBLUM AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-1216
Practice Address - Country:US
Practice Address - Phone:310-567-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2021-05-06
Deactivation Date:2019-09-18
Deactivation Code:
Reactivation Date:2021-05-06
Provider Licenses
StateLicense IDTaxonomies
CALMFT84784106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist