Individual provider Active NPI

Sydney Lewis

  • Psychiatric/Mental Health Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1003646043
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95039061 Issued in CA
Practice address
9431 Haven Ave Ste 101
Rancho Cucamonga, CA 91730-5879
Phone
(512) 876-6133
NPI assigned
Aug 5, 2024
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95039061 CA Primary

Addresses

Primary practice location

9431 Haven Ave Ste 101
Rancho Cucamonga, CA 91730-5879

Mailing address

9431 Haven Ave Ste 101
Rancho Cucamonga, CA 91730-5879
Phone (512) 876-6133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260601002937 CA Practitioner - Nurse Practitioner 2264902113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enara Family Counseling P CGroup PAC ID 0749718385, 6 clinicians

Practice addresses (Care Compare)

El Cajon, CA 92020
Phone (619) 573-1779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95039061CAMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1003646043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305879",
            "telephone_number": "512-876-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305879",
            "telephone_number": "512-876-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SYDNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95039061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.