Active NPI
Jane Lee
- Professional Counselor
- San Jose, CA
National Provider Identifier
1104619345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 23017
- Practice address
- 3880 S Bascom Ave Ste 216
San Jose, CA 95124-2675 - Phone
- (530) 290-1630
- NPI assigned
- May 28, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 23017 | CA | Primary |
Addresses
Primary practice location
3880 S Bascom Ave Ste 216
San Jose, CA 95124-2675
Mailing address
2155 Verdugo Blvd
Box #2100
Montrose, CA 91020
Phone (818) 336-1080
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Fernando Recovery Center | Past | Accepting new patients | |
| San Fernando Recovery Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- San Fernando, CA
- NPI 1164980603
-
- Substance Use Disorder Rehabilitation Clinic/Center
- San Fernando, CA
- NPI 1275478745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1104619345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2155 VERDUGO BLVD",
"address_2": "BOX #2100",
"city": "MONTROSE",
"state": "CA",
"postal_code": "91020",
"telephone_number": "818-336-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3880 S BASCOM AVE STE 216",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951242675",
"telephone_number": "530-290-1630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JANE",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-05-28",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "23017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.