Individual
DESTINI LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 E DEERE AVE STE 100, SANTA ANA, CA 92705-5718
(714) 742-2375
Mailing address
3701 PARKVIEW LN APT 7B, IRVINE, CA 92612-1855
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-GWEJLS
CA
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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