Provider Demographics
NPI:1760864284
Name:LEE, ALEXIS DEANNA
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:DEANNA
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:DEANNA
Other - Last Name:BATCHELOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,ASW
Mailing Address - Street 1:9033 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3839
Mailing Address - Country:US
Mailing Address - Phone:562-942-9625
Mailing Address - Fax:
Practice Address - Street 1:9033 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3839
Practice Address - Country:US
Practice Address - Phone:562-942-9625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-20
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health