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Individual

MR. RYAN J LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
515 NEW JERSEY ST STE A, REDLANDS, CA 92373-6249
(909) 880-4200
Mailing address
PO BOX 221, MENTONE, CA 92359-0221
(909) 353-9172

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95032558
CA

Other

Enumeration date
10/11/2024
Last updated
10/30/2024
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