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General NPI Number Information
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NPI Number | 1306867965
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Entity Type | Individual
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Provider Name | PATRICIA ANITA LEE MFT
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 27322 CALLE ARROYO STE B
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-6761
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Country | US
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Telephone | 949-246-2781
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Fax | 949-489-9064
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Provider Business Mailing Address
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Address Line | 34021 CALLE DE BONANZA
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-5026
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Country | US
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Telephone | 949-493-0931
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Fax | 949-489-9064
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFT39362
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License Number State | CA
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