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NPI Code Detail

MEDICARE: MAYNONG LEE

MEDICARE: MAYNONG 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
1101YP2500XProfessional Counselor12713CA

General Provider Information

NPI Number : 1366859209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYNONG LEE
Provider Business Mailing Address
First Line : 1925 E DAKOTA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-4821
Country : US
Telephone Number : 559-600-7137
Fax Number :
Provider Business Practice Location Address
First Line : 1925 E DAKOTA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-4821
Country : US
Telephone Number : 559-600-7137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2014
Last Update Date : 06/05/2026

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Directions to “ MAYNONG LEE ” Practice Location

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