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NPI Code Detail

MEDICARE: VERONIQUE NICOLE LEE PSY.D.

MEDICARE: VERONIQUE NICOLE LEE PSY.D.
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
1103TC0700XClinical PsychologistPSY28772CA
2103TC0700XClinical Psychologist019781NY

General Provider Information

NPI Number : 1598951311
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONIQUE NICOLE LEE PSY.D.
Provider Business Mailing Address
First Line : 400 ESTUDILLO AVE STE 100
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-4962
Country : US
Telephone Number : 510-924-0230
Fax Number :
Provider Business Practice Location Address
First Line : 400 ESTUDILLO AVE STE 100
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-4962
Country : US
Telephone Number : 510-924-0230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2007
Last Update Date : 02/25/2021

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