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General NPI Number Information
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NPI Number | 1659049773
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Entity Type | Individual
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Provider Name | JAYME VICTORIA LEE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 1401 CIVIC CT
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City | CONCORD
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State | CA
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Zip | 94520-5211
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Country | US
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Telephone | 925-301-9179
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 CAMINO VERDE APT O
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2261
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Country | US
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Telephone | 916-660-6250
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 30072
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License Number State | CA
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