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Provider Information for 1609968932


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

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GRACE MIMI LEE LCSW


Sex: Female

NPI: 1609968932
Last Updated: 2014-04-01
Certification Date:

Details

NameValue
NPI1609968932
Enumeration Date2006-09-28
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 405 W 5TH ST
SUITE #212
SANTA ANA, CA 92701-4599
United States

Phone: 714-834-2125 | Fax:
 
Primary Practice Address 405 W 5TH ST
SUITE #212
SANTA ANA, CA 92701-4599
United States

Phone: 714-834-2125 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 1041C0700X - Social Worker - ClinicalCAASW 16334
Yes 1041C0700X - Social Worker - ClinicalCALCS 28912
No 1041C0700X - Social Worker - ClinicalCAASW 27425