Provider Demographics
NPI:1538241773
Name:WEBB, LEWIS VERNON (PHD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:VERNON
Last Name:WEBB
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:711 PACIFIC COAST HWY
Mailing Address - Street 2:433
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5052
Mailing Address - Country:US
Mailing Address - Phone:213-305-2931
Mailing Address - Fax:
Practice Address - Street 1:151 KALMUS DR
Practice Address - Street 2:K-3
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5988
Practice Address - Country:US
Practice Address - Phone:800-577-4701
Practice Address - Fax:714-474-2915
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9619103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical