Active NPI
Debra D Lacy
- Marriage & Family Therapist
- Lake Elsinore, CA
National Provider Identifier
1225333438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 31946 Mission TRL Ste B
Lake Elsinore, CA 92530-4539 - Phone
- (951) 471-4300
- Fax
- (951) 674-6431
- NPI assigned
- Jan 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 86783 | CA | |
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
31946 Mission TRL Ste B
Lake Elsinore, CA 92530-4539
Mailing address
31946 Mission TRL Ste B
Lake Elsinore, CA 92530-4539
Phone (951) 471-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86783 | Other | CA | CALIFORNIA BOARD OF BEHAVIORAL SCIENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86783 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1225333438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31946 MISSION TRL STE B",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304539",
"telephone_number": "951-471-4300",
"fax_number": "951-674-6431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31946 MISSION TRL STE B",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304539",
"telephone_number": "951-471-4300",
"fax_number": "951-674-6431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACY",
"first_name": "DEBRA",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-19",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "86783",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCE",
"identifier": "86783",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
- Richard J Krottmayer Jr.
- Kaitlyn Nicole Krueger
- Kun Bai Business Inc.
- Sandar Kyi, MD
- Tera Labrosciano, M.A., CCC-SLP
- Kaleb Can Lai
- Lake Elsinore Clinica Medica Familiar a Medical Corporation (Lake Elsinore Clinica Medica Familiar)
- Lake Elsinore Congregate Care Inc.
- Lake Elsinore Diagnostics
- Lake Elsinore Unified School District
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.