Individual provider Active NPI

Seung Eun Lee, NP

  • Adult Health Nurse Practitioner
  • Menlo Park, CA
National Provider Identifier
1992076905
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
20446 Issued in CA
Practice address
795 Willow Rd
BLDG 332
Menlo Park, CA 94025-2539
Phone
(650) 324-1470
Fax
(650) 324-4149
NPI assigned
Jan 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 553556 CA
Adult Health Nurse Practitioner 363LA2200X 20446 CA Primary

Addresses

Primary practice location

795 Willow Rd
BLDG 332
Menlo Park, CA 94025-2539

Mailing address

795 Willow Rd
BLDG 332
Menlo Park, CA 94025-2539
Phone (650) 324-1470

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
553556CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1992076905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD",
            "address_2": "BLDG 332",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-324-1470",
            "fax_number": "650-324-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD",
            "address_2": "BLDG 332",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-324-1470",
            "fax_number": "650-324-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEUNG EUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "553556",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "20446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.