Provider Demographics
NPI:1639969496
Name:LEE, DAN BI (PHD)
Entity type:Individual
Prefix:DR
First Name:DAN BI
Middle Name:
Last Name:LEE
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 W CAPITOL EXPY STE 10
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-3962
Mailing Address - Country:US
Mailing Address - Phone:401-369-3692
Mailing Address - Fax:
Practice Address - Street 1:541 W CAPITOL EXPY STE 10
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-3962
Practice Address - Country:US
Practice Address - Phone:401-369-3692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027219103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical