Individual provider Active NPI

Eleanor Lew

  • Marriage & Family Therapist
  • Emeryville, CA
National Provider Identifier
1063641306
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC53260 Issued in CA
Practice address
1585 62ND St Unit 8722
Emeryville, CA 94662-7031
Phone
(510) 866-4781
NPI assigned
Jul 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC53260 CA Primary

Addresses

Primary practice location

1585 62ND St Unit 8722
Emeryville, CA 94662-7031

Mailing address

1585 62ND St Unit 8722
Emeryville, CA 94662-7031
Phone (510) 866-4781

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260220000815 CA Practitioner - Marriage and Family Therapist 0648614271 Practice locations: Emeryville, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1585 62ND St
Unit 8722
Emeryville, CA 94662-7016

1585 62ND St
Unit 8722
Emeryville, CA 94662-7031
Phone (510) 866-4781

1585 62ND St Unit
Suite 8722
Emeryville, CA 94662-7031

5604 Willow Creek LN
Richmond, VA 23225-2659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC53260CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1063641306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 62ND ST UNIT 8722",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946627031",
            "telephone_number": "510-866-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 62ND ST UNIT 8722",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946627031",
            "telephone_number": "510-866-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEW",
        "first_name": "ELEANOR",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC53260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.