Provider Demographics
NPI:1285097303
Name:LEE, ALANNA
Entity type:Individual
Prefix:MRS
First Name:ALANNA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 TECHNOLOGY DR
Mailing Address - Street 2:C/O STUDENT SUPPORT SERVICES
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-6337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4210 TECHNOLOGY DR
Practice Address - Street 2:C/O STUDENT SUPPORT SERVICES
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6337
Practice Address - Country:US
Practice Address - Phone:510-386-8435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652704163WC1500X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health