Provider Demographics
NPI:1477442994
Name:LEE, ISABELLA CORA
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:CORA
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 1:6032 KERRY RD APT 262
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2799
Mailing Address - Country:US
Mailing Address - Phone:707-770-7783
Mailing Address - Fax:
Practice Address - Street 1:6032 KERRY RD APT 262
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2799
Practice Address - Country:US
Practice Address - Phone:707-770-7783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)