Provider Demographics
NPI:1487537130
Name:LEWIS, ASHLEY INES
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:INES
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:INES
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1080 MARINA VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6427
Mailing Address - Country:US
Mailing Address - Phone:510-418-5094
Mailing Address - Fax:
Practice Address - Street 1:298 BERNAL RD STE B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1809
Practice Address - Country:US
Practice Address - Phone:408-780-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program