Crystal Dionne Lake-Akinnuoye, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95013402 Issued in CA

Practice address

582 E Harding Way
Stockton, CA 95204-6110

Phone

(888) 530-4415

NPI assigned

Mar 22, 2019

Last updated

Sep 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Crystal Dionne Lake-Anderson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: crystal.lake-akinnuoye.1@33563.direct.athenahealth.com
• Direct secure messaging: crystal.lake-akinnuoye.4@17371.direct.athenahealth.com

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694908800000",
    "number": "1053871293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "888-530-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "888-530-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE-AKINNUOYE",
        "first_name": "CRYSTAL",
        "middle_name": "DIONNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-09-17",
        "certification_date": "2023-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "CA",
            "license": "95013402",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013402",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95013402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CLAKE2359@HOTMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "E-MAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "111 Sleepy Hollow Rd",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296468831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "LAKE-ANDERSON",
            "middle_name": "DIONNE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lacy Lahman
• Fong Lai, M.D.
• Thao Lai, FNP-C
• Ellaha Yasamin Lail
• Gloria Stephen Laizer
• Abbey Lake, RD, CNSC
• Miriam Claire Lakes, NP
• Lakeside Optometry, PC
• Lakeview Dental Care Office of Louis M. Orimo, D.D.S., Inc.
• Peter Valdis Lakis, LMSW-CC

• Family Nurse Practitioner in Stockton, CA
• Providers in Stockton, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.