Provider Demographics
NPI:1326192188
Name:LEE, KARENA (PT)
Entity Type:Individual
Prefix:
First Name:KARENA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22151 CLARENDON ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6308
Mailing Address - Country:US
Mailing Address - Phone:818-884-4810
Mailing Address - Fax:818-884-4802
Practice Address - Street 1:22151 CLARENDON ST
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6308
Practice Address - Country:US
Practice Address - Phone:818-884-4810
Practice Address - Fax:818-884-4802
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 25583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist