Provider Demographics
NPI:1942967583
Name:YEE, LISA ANN (LAC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:YEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:CROSETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-0244
Mailing Address - Country:US
Mailing Address - Phone:925-548-5327
Mailing Address - Fax:
Practice Address - Street 1:702 MAIN ST # C
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3560
Practice Address - Country:US
Practice Address - Phone:530-666-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19230171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist