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:
Health care specialties
Specialty | Code | License # | 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 10 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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