Provider Demographics
NPI:1427192186
Name:LAMONT R LEE, PH.D. A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:LAMONT R LEE, PH.D. A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAMONT
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-296-0323
Mailing Address - Street 1:41707 WINCHESTER RD
Mailing Address - Street 2:STE 203
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4867
Mailing Address - Country:US
Mailing Address - Phone:951-296-0323
Mailing Address - Fax:951-245-0309
Practice Address - Street 1:41707 WINCHESTER RD
Practice Address - Street 2:STE 203
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4867
Practice Address - Country:US
Practice Address - Phone:951-296-0323
Practice Address - Fax:951-245-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5254103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL52541Medicare PIN
CAZZZ01553ZMedicare PIN