Elizabeth Nicole Lake, MA, BCBA/LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-63133 Issued in CA

Practice address

1550 Broadstone Pkwy Apt 2307
Folsom, CA 95630-6698

Phone

(805) 297-0029

NPI assigned

Feb 18, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

The complete NPPES record for this NPI in the NPI Registry API format.

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    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1033702287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 BROADSTONE PKWY APT 2307",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306698",
            "telephone_number": "805-297-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BROADSTONE PKWY APT 2307",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306698",
            "telephone_number": "805-297-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "ELIZABETH",
        "middle_name": "NICOLE",
        "credential": "MA, BCBA/LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-22-63133",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "1-22-63133",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Renee Lacefield
• Grant David Lackey, PHARM.D.
• Tina Marie Ladwig, RN
• Izabella Lafuente
• Stephanie Ping Ann Lai
• Shirley Lam
• Karyn J Lamb
• Lance Metsger DMD PC
• Johanna Andrea Lancheros
• Ngoc Khanh Landero

• Behavior Analyst in Folsom, CA
• Providers in Folsom, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.