Provider Demographics
NPI:1740750785
Name:LEE, DIANA YH (NP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:YH
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 BENICIA RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1601
Mailing Address - Country:US
Mailing Address - Phone:909-272-7781
Mailing Address - Fax:
Practice Address - Street 1:3401 W SUNFLOWER AVE STE 250
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6945
Practice Address - Country:US
Practice Address - Phone:888-789-9585
Practice Address - Fax:562-803-4500
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily