Active NPI
Kris Kyung Eun Lee
- Pediatric Occupational Therapist
- Berkeley, CA
National Provider Identifier
1396679072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 16108
- Practice address
- 2020 Bonar St
Berkeley, CA 94702-1793 - Phone
- (510) 644-6210
- NPI assigned
- Jun 9, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 16108 | CA | Primary |
Addresses
Primary practice location
2020 Bonar St
Berkeley, CA 94702-1793
Mailing address
1088 65TH St Apt a
Oakland, CA 94608-1263
Other practice location 1
2955 Claremont Ave
Berkeley, CA 94705-2449
Phone (510) 644-6410
Other practice location 2
2800 Forest Ave
Berkeley, CA 94705-1367
Phone (510) 644-6890
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1396679072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1088 65TH ST APT A",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946081263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 BONAR ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947021793",
"telephone_number": "510-644-6210"
}
],
"practiceLocations": [
{
"address_1": "2955 Claremont Ave",
"address_purpose": "LOCATION",
"city": "Berkeley",
"state": "CA",
"postal_code": "947052449",
"country_code": "US",
"telephone_number": "510-644-6410",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2800 Forest Ave",
"address_purpose": "LOCATION",
"city": "Berkeley",
"state": "CA",
"postal_code": "947051367",
"country_code": "US",
"telephone_number": "510-644-6890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "KRIS KYUNG EUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-09",
"last_updated": "2026-06-09",
"certification_date": "2026-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "16108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.