Healthcare Provider Details

I. General information

NPI: 1659235703
Provider Name (Legal Business Name): JULIE LEE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1889 LAWRENCE RD
SANTA CLARA CA
95051-2166
US

IV. Provider business mailing address

1906 MAGDALENA CIR APT 56
SANTA CLARA CA
95051-2517
US

V. Phone/Fax

Practice location:
  • Phone: 408-423-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number547725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: