Provider Demographics
NPI:1215569397
Name:LEE, PATRICIA (OCCUPATIONAL THERAPY)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OCCUPATIONAL THERAPY
Mailing Address - Street 1:2743 VETERAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4239
Mailing Address - Country:US
Mailing Address - Phone:310-980-4066
Mailing Address - Fax:
Practice Address - Street 1:2743 VETERAN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4239
Practice Address - Country:US
Practice Address - Phone:310-980-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6961225XN1300X, 225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation