Nicole Marie Lee, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000023176 Issued in CA

Practice address

6505 Reflection Dr Apt 206
San Diego, CA 92124-3108

Phone

(909) 973-9329

NPI assigned

Nov 29, 2016

Last updated

Jan 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Marie Pfutzenreuter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1588107155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RANCHO JURUPA PL",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664774",
            "telephone_number": "909-973-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 REFLECTION DR APT 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921243108",
            "telephone_number": "909-973-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "2000023176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PFUTZENREUTER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Sue Lee, M.D.
• Natalie Lee, MS, CCC-SLP
• Nathan Lee, O.D.
• Nayun Lee, MD
• Nicholas Michael Lee, IDC
• Olivia Seungmin Lee
• Pamela Cristine Lee, MD
• Patricia Lee, DMD
• Patrick Lee, M.D.
• Pauline Lee, L.AC.

• Athletic Trainer in San Diego, CA
• Providers in San Diego, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; 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.