Provider Demographics
NPI:1023361854
Name:LEE, SENA (LAC)
Entity Type:Individual
Prefix:
First Name:SENA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1660 GEARY BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3796
Mailing Address - Country:US
Mailing Address - Phone:415-441-7333
Mailing Address - Fax:415-441-1333
Practice Address - Street 1:1660 GEARY BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3796
Practice Address - Country:US
Practice Address - Phone:415-441-7333
Practice Address - Fax:415-441-1333
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8510171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist