Healthcare Provider Details

I. General information

NPI: 1629992227
Provider Name (Legal Business Name): MISS BRITANIA RENEE LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4521 SHERMAN OAKS AVE STE 101
SHERMAN OAKS CA
91403-3807
US

IV. Provider business mailing address

2965 WAVERLY DR APT 23
LOS ANGELES CA
90039-2076
US

V. Phone/Fax

Practice location:
  • Phone: 424-261-9444
  • Fax:
Mailing address:
  • Phone: 805-458-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT162934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: