Active NPI
Jonathan Lee
- Occupational Therapist
- Palm Desert, CA
National Provider Identifier
1053076893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 22802
- Practice address
- 43875 Washington St Ste G
Palm Desert, CA 92211-8249 - Phone
- (760) 701-5046
- Fax
- (888) 490-0261
- NPI assigned
- Nov 6, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 22802 | CA | Primary |
Addresses
Primary practice location
43875 Washington St Ste G
Palm Desert, CA 92211-8249
Mailing address
2152 Root St
Fullerton, CA 92833-5664
Phone (714) 326-8412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22802 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636156800000",
"number": "1053076893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2152 ROOT ST",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928335664",
"telephone_number": "714-326-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43875 WASHINGTON ST STE G",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922118249",
"telephone_number": "760-701-5046",
"fax_number": "888-490-0261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-06",
"last_updated": "2021-11-06",
"certification_date": "2021-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "22802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.