Provider Demographics
NPI:1316423171
Name:LEE, NINA (LMFT)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 E FOOTHILL BLVD # A427
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2505
Mailing Address - Country:US
Mailing Address - Phone:626-353-7817
Mailing Address - Fax:
Practice Address - Street 1:580 CALIFORNIA ST FL 12
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-1033
Practice Address - Country:US
Practice Address - Phone:415-992-6155
Practice Address - Fax:650-360-6913
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97678106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty