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General NPI Number Information
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NPI Number | 1669874459
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Entity Type | Individual
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Provider Name | RONALD LEE JR. CADC, CAS
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Gender | Male
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 13511 SUNNYVALE AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-3232
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Country | US
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Telephone | 714-659-7586
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 W 6TH ST
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City | SANTA ANA
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State | CA
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Zip | 92703-2514
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Country | US
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Telephone | 171-465-9758
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | L0907011902
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C060580919
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C060580919
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | C060580919
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C060580919
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License Number State | CA
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