Individual provider Active NPI

Stephanie Nicole Lee

  • Pharmacist
  • Chino, CA
National Provider Identifier
1750890836
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77412 Issued in CA
Practice address
5555 Philadelphia St
Chino, CA 91710
Phone
(909) 464-0063
NPI assigned
Sep 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77412 CA Primary

Addresses

Primary practice location

5555 Philadelphia St
Chino, CA 91710

Mailing address

5555 Philadelphia St
Chino, CA 91710-2481
Phone (909) 464-0063

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

LicenseStateTypeSpecialty
77412CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1750890836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PHILADELPHIA ST",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102481",
            "telephone_number": "909-464-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PHILADELPHIA ST",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "91710",
            "telephone_number": "909-464-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.