Audra K Lacey, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC38530 Issued in CA

Practice address

5480 Baltimore Dr Ste 103
La Mesa, CA 91942-2068

Phone

(619) 559-8591

Fax

(619) 271-7356

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215061254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 103",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422068",
            "telephone_number": "619-559-8591",
            "fax_number": "619-271-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 103",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422068",
            "telephone_number": "619-559-8591",
            "fax_number": "619-271-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "AUDRA",
        "middle_name": "K",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC38530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Mesa Physical Therapy, Inc
• La Mesa Surgical Services
• La Mesa Vision Care Center Optometry
• La Mesa-Spring Valley School District
• Michelle Laaper, M.S. CCC-SLP
• Amy Lack, MOT
• Christopher Mark Lafferty, M.D.
• Jonathan Lahuynh, APRN
• Maria Elena Lai, M.D.
• Michael Lajin, M.D.

• Marriage & Family Therapist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.