Provider Demographics
NPI:1134297047
Name:LEE, BETTY YVONNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:YVONNE
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 FAIR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4708
Mailing Address - Country:US
Mailing Address - Phone:916-480-6539
Mailing Address - Fax:916-480-6520
Practice Address - Street 1:2345 FAIR OAKS BLVD KAISER PERMANENTE MED 5
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-973-5243
Practice Address - Fax:916-480-6520
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233424363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P17716 ZZZ19220ZMedicare UPIN