Individual provider Active NPI

RJ Lee, RN, PHN

  • Case Management Registered Nurse
  • San Jose, CA
National Provider Identifier
1639882244
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
550628 Issued in CA
Practice address
1775 Story Rd Ste 120
San Jose, CA 95122-1942
Phone
(408) 494-1500
NPI assigned
Dec 28, 2022
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 550628 CA Primary

Addresses

Primary practice location

1775 Story Rd Ste 120
San Jose, CA 95122-1942

Mailing address

1775 Story Rd Ste 120
San Jose, CA 95122-1942
Phone (408) 494-1500

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
550628CAMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1639882244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 STORY RD STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221942",
            "telephone_number": "408-494-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 STORY RD STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221942",
            "telephone_number": "408-494-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RJ",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-28",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "550628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.