Individual provider Active NPI

Judy Lee, PH.D.

  • Clinical Psychologist
  • Santa Fe Springs, CA
National Provider Identifier
1902452394
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35459 Issued in CA
Practice address
12215 Telegraph Rd Ste 107
Santa Fe Springs, CA 90670-3344
Phone
(925) 282-1778
NPI assigned
Aug 13, 2019
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35459 CA Primary
Rehabilitation Practitioner 225400000X NU
Rehabilitation Counselor 225C00000X NU

Addresses

Primary practice location

12215 Telegraph Rd Ste 107
Santa Fe Springs, CA 90670-3344

Mailing address

12215 Telegraph Rd Ste 107
Santa Fe Springs, CA 90670-3344
Phone (925) 282-1778

Other practice location 1

11721 Telegraph Rd Ste A
Santa Fe Springs, CA 90670-6835
Phone (562) 949-8455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250320002122 CA Practitioner - Clinical Psychologist 5991227811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

12215 Telegraph Rd
Suite 107
Santa Fe Springs, CA 90670-3344
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Apr 1, 2025 Accepting new patients

Locations

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 434-0011

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

12215 Telegraph Rd
Ste 107
Santa Fe Springs, CA 90670

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1902452394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12215 TELEGRAPH RD STE 107",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703344",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12215 TELEGRAPH RD STE 107",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703344",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11721 Telegraph Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Fe Springs",
            "state": "CA",
            "postal_code": "906706835",
            "country_code": "US",
            "telephone_number": "562-949-8455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUDY",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35459",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

Verify at the official NPI Registry.