Individual provider Active NPI

Jin Hee Lee

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, CA
National Provider Identifier
1306164231
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
688474 Issued in CA
Practice address
2425 Bisso LN
100
Concord, CA 94520-4897
Phone
(925) 957-5102
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 688474 CA Primary

Addresses

Primary practice location

2425 Bisso LN
100
Concord, CA 94520-4897

Mailing address

2425 Bisso LN
100
Concord, CA 94520-4897

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

State licenses

LicenseStateTypeSpecialty
688474CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1306164231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 BISSO LN",
            "address_2": "100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BISSO LN",
            "address_2": "100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204897",
            "telephone_number": "925-957-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JIN",
        "middle_name": "HEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "688474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.