Provider Demographics
NPI:1679646756
Name:LEE, CATHY B (LAC)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:B
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:CATHERINA
Other - Middle Name:B
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:1132 E. KATELLA AVE.
Mailing Address - Street 2:SUITE A14
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867
Mailing Address - Country:US
Mailing Address - Phone:714-538-9988
Mailing Address - Fax:714-538-9988
Practice Address - Street 1:1132 E. KATELLA AVE.
Practice Address - Street 2:SUITE A14
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867
Practice Address - Country:US
Practice Address - Phone:714-538-9988
Practice Address - Fax:714-538-9988
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA7220171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC7220OtherLAC