Provider Demographics
NPI:1588471437
Name:LEE MURAKAMI, PRISTINE
Entity type:Individual
Prefix:
First Name:PRISTINE
Middle Name:
Last Name:LEE MURAKAMI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DOUGLAS BLVD STE 170
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4281
Mailing Address - Country:US
Mailing Address - Phone:855-446-8628
Mailing Address - Fax:
Practice Address - Street 1:3400 DOUGLAS BLVD STE 170
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4281
Practice Address - Country:US
Practice Address - Phone:855-446-8628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1268191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical