Individual
KEVIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1906 S PALM GROVE AVE, LOS ANGELES, CA 90016-1630
(571) 451-7470
Mailing address
1906 S PALM GROVE AVE, LOS ANGELES, CA 90016-1630
(571) 451-7470
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95034991
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/13/2024
Last updated
02/03/2026
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