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Individual

EMBER LYNN LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3665 KEARNY VILLA RD, #101, SAN DIEGO, CA 92123-1953
(858) 966-5832
Mailing address
4046 1ST AVE, #305, SAN DIEGO, CA 92103-2036
(334) 707-0380

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95-1691313
RADY CHILDREN'S HOSPITAL SAN DIEGO, OUTPATIENT PSYCHIATRY DEPARTMENT
CA
Enumeration date
06/22/2008
Last updated
06/22/2008
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