Active NPI
Jieun Lee, BCBA
- Behavior Analyst
- Riverside, CA
National Provider Identifier
1952947855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12045564
- Practice address
- 5750 Division St Ste 104
Riverside, CA 92506-3259 - Phone
- (951) 900-6390
- NPI assigned
- Nov 26, 2019
- Last updated
- Nov 28, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 12045564 | CA | Primary |
Addresses
Primary practice location
5750 Division St Ste 104
Riverside, CA 92506-3259
Mailing address
21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345
Other practice location 1
625 The City Dr S Ste 120
Orange, CA 92868-3352
Phone (866) 727-8274
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12045564 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Envision Pediatric Therapy | Behavior Analyst | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Laguna Niguel, CA
- NPI 1790464204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606521600000",
"number": "1952947855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21600 OXNARD ST STE 1800",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913677807",
"telephone_number": "818-345-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5750 DIVISION ST STE 104",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063259",
"telephone_number": "951-900-6390"
}
],
"practiceLocations": [
{
"address_1": "625 The City Dr S Ste 120",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "928683352",
"country_code": "US",
"telephone_number": "866-727-8274",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "JIEUN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-26",
"last_updated": "2020-11-28",
"certification_date": "2020-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "12045564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.