Provider Demographics
NPI:1265011001
Name:JPL MENTAL HEALTH
Entity Type:Organization
Organization Name:JPL MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:747-999-5313
Mailing Address - Street 1:14860 ROSCOE BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4695
Mailing Address - Country:US
Mailing Address - Phone:949-246-9750
Mailing Address - Fax:906-254-3118
Practice Address - Street 1:14860 ROSCOE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4695
Practice Address - Country:US
Practice Address - Phone:949-246-9750
Practice Address - Fax:906-254-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty