Provider Demographics
NPI:1538911953
Name:LEE, HYUN JU (LMFT, PHD)
Entity type:Individual
Prefix:
First Name:HYUN
Middle Name:JU
Last Name:LEE
Suffix:
Gender:F
Credentials:LMFT, PHD
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8056
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91224-0056
Mailing Address - Country:US
Mailing Address - Phone:213-744-0060
Mailing Address - Fax:
Practice Address - Street 1:5152 KATELLA AVE STE 205
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2846
Practice Address - Country:US
Practice Address - Phone:213-744-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALMFT146052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health