Provider Demographics
NPI:1104329317
Name:LEE, DARREN (MS, BCBA)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2385 TROUSDALE DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-5704
Mailing Address - Country:US
Mailing Address - Phone:650-259-3800
Mailing Address - Fax:
Practice Address - Street 1:2385 TROUSDALE DR
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-5704
Practice Address - Country:US
Practice Address - Phone:650-259-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA3FA44C5307171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171400000XOther Service ProvidersHealth & Wellness Coach