Provider Demographics
NPI:1912201476
Name:LEE, ANNA (LMFT93402)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:LEE
Suffix:
Gender:
Credentials:LMFT93402
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W F ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3201
Mailing Address - Country:US
Mailing Address - Phone:909-986-4550
Mailing Address - Fax:909-986-4506
Practice Address - Street 1:1211 W VISTA WAY BLDG C
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6227
Practice Address - Country:US
Practice Address - Phone:760-721-2781
Practice Address - Fax:760-721-9571
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT93402106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist