Healthcare Provider Details

I. General information

NPI: 1669519732
Provider Name (Legal Business Name): LISA ANNE MARIE YEE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WEBSTER ST STE 101
OAKLAND CA
94609-3106
US

IV. Provider business mailing address

PO BOX 31396
WALNUT CREEK CA
94598-8396
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax:
Mailing address:
  • Phone: 925-939-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number8741
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number1031100359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: