Provider Demographics
NPI:1548477938
Name:LEE, NANCY FRANCINE (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:FRANCINE
Last Name:LEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 906
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3121
Mailing Address - Country:US
Mailing Address - Phone:310-657-7034
Mailing Address - Fax:310-652-5742
Practice Address - Street 1:8500 WILSHIRE BLVD
Practice Address - Street 2:SUITE 906
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3121
Practice Address - Country:US
Practice Address - Phone:310-657-7034
Practice Address - Fax:310-652-5742
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10140103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP10140Medicare ID - Type UnspecifiedPSYCHOLOGIST