Ella Rose NMN Lee, RADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1465840422 Issued in CA

Practice address

3594 4TH Ave
San Diego, CA 92103-4989

Phone

(619) 296-1151

Fax

(619) 296-6218

NPI assigned

Jun 16, 2022

Last updated

Oct 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crossroads Foundation

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1881819621
  NPD (past)

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1568192953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3594 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034989",
            "telephone_number": "619-296-1151",
            "fax_number": "619-296-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3594 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034989",
            "telephone_number": "619-296-1151",
            "fax_number": "619-296-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ELLA ROSE",
        "middle_name": "NMN",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1465840422",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "R1465840422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ellarose@crossroads4recovery.org",
            "affiliation": "N",
            "address_1": "3594 4th Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921034989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah San Lee, D.O.
• Diana Lee
• Diedra Lee, AMFT
• Edith Kyu Lee, PHARMD
• Eliot Justin Lee, PT, DPT
• Ember Lynn Lee
• Emily Ann Lee, NURSE PRACTITIONER
• Erina Lee, D.D.S
• Eunice Lee
• Evelyn Lee

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.