Young Tae Lee, PNHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95019749 Issued in CA

Practice address

30423 Canwood St Ste 123
Agoura Hills, CA 91301-4314

Phone

(818) 385-1219

Fax

(818) 385-1600

NPI assigned

Jan 18, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Medi Psych Services IncGroup PAC ID 3870908320, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medi Psych Services Inc

  • Child & Adolescent Psychiatry Physician
  • Sherman Oaks, CA
  • NPI 1326665316
  Medicare reassignment Care Compare group NPD
• J M Geiss DO Apc

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1063825289
  NPD
• Robert P Kahn-Rose, Inc.

  • Specialist
  • Agoura Hills, CA
  • NPI 1407936784
  NPD
• Mental Health Practitioners

  • Psychiatric/Mental Health Nurse Practitioner
  • Sonoma, CA
  • NPI 1609763341
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1225780562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 123",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "818-385-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 123",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "818-385-1219",
            "fax_number": "818-385-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YOUNG TAE",
        "credential": "PNHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-18",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019749",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95158737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Las Virgenes Behavioral Health and Medical Clinic, Inc
• Laura Lapiana, Psy.D., a Prof. Corp.
• Alison Jamie Lee, PH.D.
• Grace Yue Lee, O.M.D.
• Yoocheol Lee, LAC
• Tal Leead, PSY.D.
• Laurie Lefkowitz, MFT
• Leisure Living Properties Inc
• Kenneth Wayne Leopold, DDS
• Tal Leshem

• Psychiatric/Mental Health Nurse Practitioner in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.