Healthcare Provider Details

I. General information

NPI: 1215696620
Provider Name (Legal Business Name): JANET PEARL LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N ACACIA AVE
FULLERTON CA
92831-3413
US

IV. Provider business mailing address

619 N ACACIA AVE
FULLERTON CA
92831-3413
US

V. Phone/Fax

Practice location:
  • Phone: 408-499-5522
  • Fax:
Mailing address:
  • Phone: 408-499-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number802379
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number802379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: