Active NPI
Justin Sewon Lee, M.A.
- Student in an Organized Health Care Education/Training Program
- Oakland, CA
National Provider Identifier
1750566105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- IMF 75918
- Practice address
- 401 Roland Way
Oakland, CA 94621-2034 - Phone
- (510) 746-2800
- NPI assigned
- Jan 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | IMF 75918 | CA | Primary |
Addresses
Primary practice location
401 Roland Way
Oakland, CA 94621-2034
Mailing address
14267 Lodgepole Dr
Penn Valley, CA 95946-9574
Phone (408) 858-9490
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 75918 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476316800000",
"number": "1750566105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14267 LODGEPOLE DR",
"city": "PENN VALLEY",
"state": "CA",
"postal_code": "959469574",
"telephone_number": "408-858-9490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 ROLAND WAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946212034",
"telephone_number": "510-746-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JUSTIN",
"middle_name": "SEWON",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-04",
"last_updated": "2016-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "IMF 75918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.