Provider Demographics
NPI:1508991472
Name:LEE, CECILE (MD)
Entity Type:Individual
Prefix:
First Name:CECILE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 21ST ST
Mailing Address - Street 2:OAKLAND BEHAVIORAL HEALTH
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1605
Mailing Address - Country:US
Mailing Address - Phone:510-587-3495
Mailing Address - Fax:
Practice Address - Street 1:525 21ST ST
Practice Address - Street 2:OAKLAND BEHAVIORAL HEALTH
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1605
Practice Address - Country:US
Practice Address - Phone:510-587-3495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010835082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry