Provider Demographics
NPI:1275288284
Name:PADDEN, LEE AMARIS (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:AMARIS
Last Name:PADDEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28441 RANCHO CALIFORNIA RD STE 207
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3677
Mailing Address - Country:US
Mailing Address - Phone:951-519-9105
Mailing Address - Fax:
Practice Address - Street 1:28441 RANCHO CALIFORNIA RD STE 207
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3677
Practice Address - Country:US
Practice Address - Phone:951-519-9105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123797106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist