MEDICARE: DR. DEBORAH L LEE PHD

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
1	101YM0800X	Mental Health Counselor	PSY15021	CA

General Provider Information

NPI Number	:	1538384755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH L LEE PHD

Provider Business Mailing Address
First Line	:	4430 BALBOA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-2437
Country	:	US
Telephone Number	:	415-722-1294
Fax Number	:	415-752-9418

Provider Business Practice Location Address
First Line	:	257 CONNECTICUT ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94107-2402
Country	:	US
Telephone Number	:	415-722-1294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2007
Last Update Date	:	07/08/2007

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