Provider Demographics
NPI:1902120314
Name:LEE, PEGGY Y
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:Y
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2166 HAYES ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1033
Mailing Address - Country:US
Mailing Address - Phone:415-213-8050
Mailing Address - Fax:415-876-6850
Practice Address - Street 1:2166 HAYES ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1033
Practice Address - Country:US
Practice Address - Phone:415-213-8050
Practice Address - Fax:415-876-6850
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)