Healthcare Provider Details

I. General information

NPI: 1700705340
Provider Name (Legal Business Name): CARISSA LEE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26831 ALISO CREEK RD STE 200
ALISO VIEJO CA
92656-5341
US

IV. Provider business mailing address

26831 ALISO CREEK RD STE 200
ALISO VIEJO CA
92656-5341
US

V. Phone/Fax

Practice location:
  • Phone: 949-760-9222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: