Matthew Jasun Lee, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1080257

Practice address

15630 18TH Ave
Clearlake, CA 95422-9336

Phone

(707) 995-5842

NPI assigned

May 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1740804368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 LAKESHORE BLVD APT 1",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536640",
            "telephone_number": "443-889-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 18TH AVE",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229336",
            "telephone_number": "707-995-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MATTHEW",
        "middle_name": "JASUN",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1080257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon K Larock, CNN
• Jasmine Lau, PHARMD
• Timothy Eve Laubach
• Kimberly M Layton Paonessa
• Natalie Ledezma
• Tabatha Lynn Leishman, SUDRC
• Morton S Levine, M.D.
• Suzan Lewil, APRN, PMHNP-BC
• Jenna Danielle Lewis
• Chifan Lin

• Registered Dietitian in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Registered Dietitian in California

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