Provider Demographics
NPI:1093946212
Name:LEE, JESSICA K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:K
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10990 SAN DIEGO MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2417
Mailing Address - Country:US
Mailing Address - Phone:619-589-3220
Mailing Address - Fax:619-589-3266
Practice Address - Street 1:8010 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2104
Practice Address - Country:US
Practice Address - Phone:619-589-3220
Practice Address - Fax:619-589-3266
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist