Provider Demographics
NPI:1649662040
Name:LEE, JUNGHEE (NP)
Entity type:Individual
Prefix:
First Name:JUNGHEE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JUNG
Other - Middle Name:HEE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:16250 SAND CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3714
Mailing Address - Country:US
Mailing Address - Phone:949-727-5200
Mailing Address - Fax:949-727-5299
Practice Address - Street 1:16250 SAND CANYON AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3714
Practice Address - Country:US
Practice Address - Phone:949-727-5200
Practice Address - Fax:949-727-5299
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF 95001945164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse