Healthcare Provider Details

I. General information

NPI: 1700167681
Provider Name (Legal Business Name): ANDREA DANIELLE LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4546 EL CAMINO REAL STE B7
LOS ALTOS CA
94022-1069
US

IV. Provider business mailing address

1324 W MAIN ST
FRANKLIN TN
37064-3784
US

V. Phone/Fax

Practice location:
  • Phone: 866-362-4246
  • Fax: 650-260-6030
Mailing address:
  • Phone: 615-794-1542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95036065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000182403
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: