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

Kevin Lee

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1063255560

Kevin Lee is a Nurse Practitioner in Los Angeles, California. Qualified in 2025, 1 year ago. Practices as a sole proprietor and works from 3 locations. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2024
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Practice location Address checks out

1906 S Palm Grove Ave
Los Angeles, CA 90016-1630
Phone: (571) 451-7470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2409 N Sepulveda Blvd Ste 205, Manhattan Beach, CA 90266-2946 — (909) 353-2947
  • 1113 Alta Ave Ste 106, Upland, CA 91786-2803 — (909) 353-2947

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95034991 (CA)

Record details

NPI number1063255560
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 13, 2024
Last updated in NPPESFebruary 3, 2026
Certification dateFebruary 3, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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