Eun Jeong Lee, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95000614 Issued in CA

Practice address

3104 Ponte Morino Dr Ste 110
Cameron Park, CA 95682-8282

Phone

(530) 621-7700

Fax

(530) 621-7713

NPI assigned

Jul 2, 2014

Sex

Female

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1952717670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11594 BIG FOUR WAY",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956708211",
            "telephone_number": "530-510-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 PONTE MORINO DR STE 110",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828282",
            "telephone_number": "530-621-7700",
            "fax_number": "530-621-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUN",
        "middle_name": "JEONG",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95000614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Kruck
• Ladder Treatment Services Management LLC (Exalted Treatment Centers)
• James E Larsen, LMFT
• Je'Tai Lawson
• Hai Le, M.D.
• Winnie Lei, O.D.
• Monique Michaela Lemire
• Graham Leupp, DMD
• LMZ Helping Others, Inc (Homewatch CareGivers)
• Ernest Lo, MD

• Nurse Practitioner in Cameron Park, CA
• Providers in Cameron Park, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.