Provider Demographics
NPI:1578004784
Name:ALANYA VAENE LEE, CLINICAL PSYCHOLOGIST INC.
Entity Type:Organization
Organization Name:ALANYA VAENE LEE, CLINICAL PSYCHOLOGIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAENE LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-222-9060
Mailing Address - Street 1:5752 OBERLIN DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121
Mailing Address - Country:US
Mailing Address - Phone:858-222-9060
Mailing Address - Fax:858-437-9960
Practice Address - Street 1:5752 OBERLIN DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121
Practice Address - Country:US
Practice Address - Phone:858-222-9060
Practice Address - Fax:858-437-9960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 28196103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty