Dae Peter Lee, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23104 Issued in CA

Practice address

12220 Foothill Blvd
Sylmar, CA 91342-6001

Phone

(818) 934-8841

NPI assigned

Dec 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1851620439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N LINCOLN ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062112",
            "telephone_number": "714-552-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12220 FOOTHILL BLVD",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913426001",
            "telephone_number": "818-934-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAE",
        "middle_name": "PETER",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-10",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23104",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "PSY23104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Le, MD, MS
• Sandra Leal-Lopez, M.A. MFT
• Sara Leconte, MFT
• Beatriz Leida Ledezma
• Albert Lee, M.D.
• In Sook Lee
• Jason P Lee, MD
• Jean Lee
• Jessica Sora Lee, M.S., M.D.
• Joshua Lee, MD

• Clinical Psychologist in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.