Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derric Justin Lee, DPT

Individual provider Physical Therapist · NPI 1255008421

Derric Justin Lee, DPT is a Physical Therapist in Private Practice in Berkeley, California. Qualified in 2021, 5 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

2030 Addison St Ste 101
Berkeley, CA 94704-1140
Phone: (510) 644-8031
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT300515 (CA)

Record details

NPI number1255008421
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 25, 2021
Last updated in NPPESAugust 25, 2021
Certification dateAugust 25, 2021
Mailing address18 Steuben Bay, Alameda, CA 94502-6406

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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