Individual provider Active NPI

Clara Lee, MD

  • Child & Adolescent Psychiatry Physician
  • San Jose, CA
National Provider Identifier
1528297645
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A119777 Issued in CA
Practice address
1555 Parkmoor Ave
San Jose, CA 95128-2407
Phone
(408) 282-0402
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A119777 CA Primary
Psychiatry Physician 2084P0800X A119777 CA
Child & Adolescent Psychiatry Physician 2084P0804X 45360 AZ

Addresses

Primary practice location

1555 Parkmoor Ave
San Jose, CA 95128-2407

Mailing address

1555 Parkmoor Ave
San Jose, CA 95128-2407

Other practice location 1

25 Allen Street
Suite B
Martinez, CA 94553
Phone (408) 379-3790

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141106001800 CA Practitioner - Psychiatry 6204058225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rush Medical College of Rush University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope ServicesGroup PAC ID 5597716233, 29 clinicians

Practice addresses (Care Compare)

1555 Parkmoor Ave
San Jose, CA 95128-2407
Phone (408) 282-0402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A119777CAMDPsychiatry Physician
45360AZMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services CurrentSince Mar 20, 2022 Accepting new patients
Hope Services CurrentSince Sep 2, 2014 Accepting new patients

Locations

1555 Parkmoor Ave
San Jose, CA 95128
Phone (408) 282-0402

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1528297645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 PARKMOOR AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 PARKMOOR AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282407",
            "telephone_number": "408-282-0402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Allen Street",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "CA",
            "postal_code": "94553",
            "country_code": "US",
            "telephone_number": "408-379-3790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CLARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A119777",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A119777",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AZ",
            "license": "45360",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.