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NPI Code Detail

MEDICARE: KRYSTEN LEE

MEDICARE: KRYSTEN LEE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1073181178
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTEN LEE
Provider Business Mailing Address
First Line : PO BOX 5157
Second Line :
City : MODESTO
State : CA
Zip : 95352-5157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3100 OAK RD STE 100
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94597-2078
Country : US
Telephone Number : 209-877-7844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2021
Last Update Date : 01/05/2026

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Directions to “ KRYSTEN LEE ” Practice Location

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