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NPI Code Detail

MEDICARE: TONNA LEE

MEDICARE: TONNA 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
11041C0700XClinical Social WorkerASW65947CA

General Provider Information

NPI Number : 1073971354
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONNA LEE
Provider Business Mailing Address
First Line : PO BOX 2604
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91729-2604
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1441 N D ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-4747
Country : US
Telephone Number : 909-388-1239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2016
Last Update Date : 02/02/2016

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Directions to “ TONNA LEE ” Practice Location

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