Healthcare Provider Details

I. General information

NPI: 1164341566
Provider Name (Legal Business Name): LEE PREUSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4193 FLAT ROCK DR STE 200
RIVERSIDE CA
92505-7113
US

IV. Provider business mailing address

4193 FLAT ROCK DR STE 200
RIVERSIDE CA
92505-7113
US

V. Phone/Fax

Practice location:
  • Phone: 951-292-4693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: