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NPI Code Detail

MEDICARE: JEONGMIN LEE PPS IN COUNSELING

MEDICARE: JEONGMIN LEE PPS IN COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YS0200XSchool Counselor220139662CA

General Provider Information

NPI Number : 1053274084
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEONGMIN LEE PPS IN COUNSELING
Provider Business Mailing Address
First Line : 2801 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3113
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2801 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3113
Country : US
Telephone Number : 213-867-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2025
Last Update Date : 12/05/2025

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Directions to “ JEONGMIN LEE PPS IN COUNSELING” Practice Location

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