Lee, Young Tae

Lee, Young Tae is an individual health care provider with primary practice located at 30423 Canwood St Ste 123 , Agoura Hills CA 91301-4314. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Lee, Young Tae can be contacted via phone (818) 385-1219.

Contact Information

Primary practice address
30423 Canwood St Ste 123 Agoura Hills CA 91301-4314
Phone: (818) 385-1219
Fax: (818) 385-1600
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95019749 California
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 95158737 California

Profile Details

NPI number 1225780562
LBN Legal business name Lee, Young Tae
Credentials PNHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2022
Last updated Feb 22nd, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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