Individual provider Active NPI

Maria Jose Lewis

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1861050460
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062
Phone
(323) 361-3849
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X
Psychologist 103T00000X Primary

Addresses

Primary practice location

4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062

Mailing address

541 Bella Dr
Newbury Park, CA 91320-3002
Phone (210) 569-9035

Other practice location 1

200 Cherry St Apt 1225
College Station, TX 77840-1532
Phone (210) 569-9035

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
I20240207002993 CA Practitioner - Clinical Psychologist 8820431703 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Cottage Clinical Associates CurrentSince Jun 15, 2024 Accepting new patients
Arc Psychological Services Inc Psychologist Past Accepting new patients
Cottage Medical Foundation PastSince Jul 1, 2025 Accepting new patients

Locations

5333 Hollister Ave
Santa Barbara, CA 93111
Phone (805) 879-4272

4360 E Main St
Ste B2A
Ventura, CA 93003
Phone (805) 879-4240

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1861050460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 BELLA DR",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913203002",
            "telephone_number": "210-569-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-3849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Cherry St Apt 1225",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778401532",
            "country_code": "US",
            "telephone_number": "210-569-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARIA",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.