Provider Demographics
NPI:1003536160
Name:LEE, ANNE CECELIA (LM, CPM)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CECELIA
Last Name:LEE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:MRS
Other - First Name:ANNIE
Other - Middle Name:LEE
Other - Last Name:HIGDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:238 E. COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2930
Mailing Address - Country:US
Mailing Address - Phone:323-363-3066
Mailing Address - Fax:951-200-4396
Practice Address - Street 1:577 E. ELDER ST
Practice Address - Street 2:SUITE H
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2930
Practice Address - Country:US
Practice Address - Phone:760-645-3447
Practice Address - Fax:951-200-4396
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM675367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife