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MR. KELLY A LEWIS PT
NPI 1497006662
Licensed Psychiatric Technician in San Luis Obispo, CA

Active since September 27, 2012
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401(805) 781-4394 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Kelly A Lewis Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KELLY A LEWIS PT (NPI 1497006662) is an individual licensed psychiatric technician in San Luis Obispo, California, licensed in California (PT36628) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1497006662
Entity TypeIndividualMale
Primary Taxonomy167G00000X
Provider Legal NameMR. KELLY A LEWISCredential: PT
Location Address2180 JOHNSON AVESan Luis Obispo, CA 93401-4513
Mailing Address2178 Johnson AveSan Luis Obispo, CA 93401-4535 · (805) 781-4868
Phone(805) 781-4394
Sole ProprietorNo
Enumeration DateSeptember 27, 2012
Last NPPES UpdateMay 29, 2025
NPPES CertifiedMay 29, 2025
✔ NPI 1497006662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers
Taxonomy Code167G00000X
License✔ Licensed in CA · PT36628
Definition
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
2180 JOHNSON AVE, San Luis Obispo, CA 93401
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JEFFREY WHITE
Counselor (Addiction (Substance Use Disorder))
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-1295
SEAN MARSHALL GALLOWAY
Licensed Psychiatric Technician
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4275
ANDREW LORIMER COOK
Licensed Psychiatric Technician
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 471-4308
KONIKA ROSENBAUM MCPHERSON MFTI
Marriage & Family Therapist
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4865
ELBA M VASQUEZ
Community Health Worker
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4275
MRS. ERIN KELLY TAYLOR
Counselor (Addiction (Substance Use Disorder))
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4275
AVERY JOHN PAULSON RN, NP
Nurse Practitioner (Psychiatric/Mental Health)
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 431-1334
KATHERINE MAIREAD TREACY
Counselor (Addiction (Substance Use Disorder))
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4753

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Lewis's NPI number?

The NPI number for Kelly Lewis is 1497006662. It was assigned to this individual provider in the NPPES registry on September 27, 2012.

Where is Kelly Lewis located?

Kelly Lewis practices at 2180 Johnson Ave, San Luis Obispo, CA 93401. The listed phone number is (805) 781-4394.

What is Kelly Lewis's specialty?

The primary specialty registered for this NPI is Licensed Psychiatric Technician with taxonomy code 167G00000X.

When was this NPI record last updated?

The NPPES record for Kelly Lewis was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.