Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 6961 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 6961 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 6961 | CA |
NPI | 1215569397 |
---|---|
Provider Name | Patricia Lee |
First Address | Los Angeles, CA 90064-4239 |
Second Address | Los Angeles, CA 90064-4239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2020 |
Last Update Date | 06/02/2020 |