Active NPI
Elise Janine Lee, NP-C
- Family Nurse Practitioner
- Walnut Creek, CA
National Provider Identifier
1336701853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95012084
- Practice address
- 355 Lennon LN Ste 150
Walnut Creek, CA 94598-2475 - Phone
- (925) 930-9373
- Fax
- (925) 945-3850
- NPI assigned
- Jul 4, 2019
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95012084 | CA | Primary |
Addresses
Primary practice location
355 Lennon LN Ste 150
Walnut Creek, CA 94598-2475
Mailing address
355 Lennon LN Ste 150
Walnut Creek, CA 94598-2475
Phone (925) 930-9373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95012084 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562198400000",
"number": "1336701853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 LENNON LN STE 150",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982475",
"telephone_number": "925-930-9373",
"fax_number": "925-945-3850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 LENNON LN STE 150",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982475",
"telephone_number": "925-930-9373",
"fax_number": "925-945-3850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ELISE",
"middle_name": "JANINE",
"credential": "NP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-04",
"last_updated": "2019-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95012084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.