Active NPI
Jenny Haeyeon Lee, PSY.D.
- Clinical Psychologist
- Redlands, CA
National Provider Identifier
1609317098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY29033
- Practice address
- 1686 Barton Rd
Redlands, CA 92373-1488 - Phone
- (909) 558-9500
- NPI assigned
- Mar 17, 2017
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY29033 | CA | Primary |
Addresses
Primary practice location
1686 Barton Rd
Redlands, CA 92373-1488
Mailing address
11130 Anderson St
Loma Linda University, Department of Psychology
Loma Linda, CA 92350-1729
Phone (909) 558-8578
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY29033 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489708800000",
"number": "1609317098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11130 ANDERSON ST",
"address_2": "LOMA LINDA UNIVERSITY, DEPARTMENT OF PSYCHOLOGY",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501729",
"telephone_number": "909-558-8578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1686 BARTON RD",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923731488",
"telephone_number": "909-558-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JENNY",
"middle_name": "HAEYEON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-17",
"last_updated": "2017-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY29033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.