Provider Demographics
NPI:1427690965
Name:LEE, PATRICIA YUNG
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:YUNG
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 1:19434 DE HAVILLAND CT
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4040
Mailing Address - Country:US
Mailing Address - Phone:408-890-1741
Mailing Address - Fax:
Practice Address - Street 1:19434 DE HAVILLAND CT
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4040
Practice Address - Country:US
Practice Address - Phone:408-890-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58089363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant