Provider Demographics
NPI:1861512626
Name:LEE, JANELLE Y (ACU)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:Y
Last Name:LEE
Suffix:
Gender:F
Credentials:ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12880 RANCHO PENASQUITOS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2966
Mailing Address - Country:US
Mailing Address - Phone:858-484-2000
Mailing Address - Fax:858-484-3414
Practice Address - Street 1:12880 RANCHO PENASQUITOS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2966
Practice Address - Country:US
Practice Address - Phone:858-484-2000
Practice Address - Fax:858-484-3414
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11437171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist