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General NPI Number Information
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NPI Number | 1134373038
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Entity Type | Individual
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Provider Name | JULIE HAE BIN KWON LEE PH.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 07/28/2024
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Provider Practice Location Address
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Address Line | 101 S KRAEMER BLVD STE 208
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City | PLACENTIA
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State | CA
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Zip | 92870-6110
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Country | US
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Telephone | 657-315-3940
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Fax |
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Provider Business Mailing Address
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Address Line | 170 E YORBA LINDA BLVD # 308
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City | PLACENTIA
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State | CA
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Zip | 92870-3327
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Country | US
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Telephone | 657-315-3940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 91277
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License Number State | CA
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