Healthcare Provider Details

I. General information

NPI: 1255240503
Provider Name (Legal Business Name): MRS. TRISHA LEE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 W 80TH ST
LOS ANGELES CA
90045-1127
US

IV. Provider business mailing address

6550 W 80TH ST 6550 W. 80TH STREET
LOS ANGELES CA
90045-1127
US

V. Phone/Fax

Practice location:
  • Phone: 310-642-9474
  • Fax:
Mailing address:
  • Phone: 310-642-9474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: