Provider Demographics
NPI:1881664993
Name:LEE, JANET KEI (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:KEI
Last Name:LEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2834
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:CA
Mailing Address - Zip Code:95223-2834
Mailing Address - Country:US
Mailing Address - Phone:209-795-3588
Mailing Address - Fax:209-795-6785
Practice Address - Street 1:2116 HIGHWAY 4
Practice Address - Street 2:ACORN PHYSICAL THERAPY
Practice Address - City:ARNOLD
Practice Address - State:CA
Practice Address - Zip Code:95223-2834
Practice Address - Country:US
Practice Address - Phone:209-795-3588
Practice Address - Fax:209-795-6785
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 9740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT97400Medicare ID - Type Unspecified