Healthcare Provider Details

I. General information

NPI: 1205772738
Provider Name (Legal Business Name): KAUL LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NORCROSS LN
OAKLEY CA
94561-2189
US

IV. Provider business mailing address

91 MERCEDES LN
OAKLEY CA
94561-4617
US

V. Phone/Fax

Practice location:
  • Phone: 925-625-7050
  • Fax:
Mailing address:
  • Phone: 925-625-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: