Healthcare Provider Details

I. General information

NPI: 1902554389
Provider Name (Legal Business Name): SEE TANG ACSW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SEE LEE MSW

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1382 BLUE OAKS BLVD STE 213
ROSEVILLE CA
95678-7052
US

IV. Provider business mailing address

15609 PUMPKIN PL
FONTANA CA
92336-3586
US

V. Phone/Fax

Practice location:
  • Phone: 916-400-0533
  • Fax:
Mailing address:
  • Phone: 909-942-1941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW100279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: