Active NPI
Andrea Corina Lee, MS, OTR/L
- Occupational Therapist
- San Ramon, CA
National Provider Identifier
1164947545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17659
- Practice address
- 2210 Goldenrod LN
San Ramon, CA 94582-5548 - Phone
- (925) 858-9403
- NPI assigned
- Aug 7, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17659 | CA | Primary |
Addresses
Primary practice location
2210 Goldenrod LN
San Ramon, CA 94582-5548
Mailing address
2210 Goldenrod Lane
San Ramon, CA 94582
Phone (925) 858-9403
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17659 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502064000000",
"number": "1164947545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2210 GOLDENROD LANE",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "94582",
"telephone_number": "19258589403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2210 GOLDENROD LN",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945825548",
"telephone_number": "925-858-9403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ANDREA",
"middle_name": "CORINA",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-07",
"last_updated": "2017-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "17659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.