Individual
KIMBERLY ANTONETTE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C; PMHNP-BC
Contact information
Practice address
10511 S WESTERN AVE, LOS ANGELES, CA 90047-4458
(424) 789-4919
(323) 305-3405
Mailing address
2851 W 120TH ST STE E242, HAWTHORNE, CA 90250-3395
(424) 223-0421
(323) 305-3402
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95007992
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95007992
CA
Other
Enumeration date
01/30/2018
Last updated
01/11/2023
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