MEDICARE: NANCY LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	12331	CA

General Provider Information

NPI Number	:	1134074362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY LEE

Provider Business Mailing Address
First Line	:	1955 OAK ST
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4957
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 ARLINGTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4552
Country	:	US
Telephone Number	:	626-676-1791
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ NANCY LEE ” Practice Location

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