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General NPI Number Information
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NPI Number | 1962216671
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Entity Type | Individual
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Provider Name | ADRIENNE ROSE LEE ASW
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 984 BOSTWICK LN
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City | SANTA CRUZ
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State | CA
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Zip | 95062-1775
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Country | US
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Telephone | 831-475-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 FRESNO ST
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City | SANTA CRUZ
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State | CA
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Zip | 95062-5329
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW124427
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License Number State | CA
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