Provider Demographics
NPI:1730277211
Name:LEE, VANESSA ANN (NP)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:ANN
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 W PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-6767
Mailing Address - Country:US
Mailing Address - Phone:562-428-0576
Mailing Address - Fax:
Practice Address - Street 1:5901 E. 7TH ST.
Practice Address - Street 2:VA LONG BEACH HCS
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:562-826-5765
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13010363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care