Healthcare Provider Details

I. General information

NPI: 1265714281
Provider Name (Legal Business Name): KATHERINE LEE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4299 ROSEWOOD DR UNIT 105
PLEASANTON CA
94588-3001
US

IV. Provider business mailing address

PO BOX 2012
DUBLIN CA
94568-0201
US

V. Phone/Fax

Practice location:
  • Phone: 925-416-1888
  • Fax: 925-416-1889
Mailing address:
  • Phone: 925-364-4607
  • Fax: 925-416-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14169
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: