Provider Demographics
NPI:1144470279
Name:VAENE LEE, ALANYA (PHD)
Entity type:Individual
Prefix:
First Name:ALANYA
Middle Name:
Last Name:VAENE LEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALANYA
Other - Middle Name:
Other - Last Name:VAENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 261424
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92196-1424
Mailing Address - Country:US
Mailing Address - Phone:858-222-9060
Mailing Address - Fax:
Practice Address - Street 1:4445 EASTGATE MALL STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1979
Practice Address - Country:US
Practice Address - Phone:858-222-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28196103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist