LEE MARSHALL FAGEN NP NPI 1275639098

NPI Information

  • NPI: 1275639098
  • Provider Name: LEE MARSHALL FAGEN, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • Address: 2222 BANCROFT EXT
    BERKELEY, CA
    ZIP 94720
  • Phone: (510) 643-9135

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NPI Details

Lee Marshall Fagen, NP is an adult health nurse practitioner in Berkeley, CA. Lee Marshall Fagen, NP NPI is 1275639098. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2222 BANCROFT EXT
BERKELEY, CA
ZIP 94720-303
Phone: (510) 643-9135

The enumeration date for this NPI number is 9/16/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthRN373234, NP7501CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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