Claudia Katherine Lake, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2322 Issued in OR

Practice address

228 NW B St
Upper Unit
Grants Pass, OR 97526-2032

Phone

(541) 761-6764

Fax

(541) 592-6479

NPI assigned

Jun 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Options for Southern Oregon

  • Primary Care Clinic/Center
  • Grants Pass, OR
  • NPI 1952708422
  NPD (past)

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1376745448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1665",
            "city": "CAVE JUNCTION",
            "state": "OR",
            "postal_code": "975231665",
            "telephone_number": "541-761-6764",
            "fax_number": "541-592-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 NW B ST",
            "address_2": "UPPER UNIT",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262032",
            "telephone_number": "541-761-6764",
            "fax_number": "541-592-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "CLAUDIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 16678",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376345448",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey M Krolick
• Jason Zachary Kryzak, LMT
• Alvin R. Kubat, PH.D.
• Kurt a Brewster MD PC
• Laboratory Corporation of America
• Drew Erica Lakey
• Denise Lamb
• Kiana Marie Lambert, OD
• Samantha Lambrecht
• Rachel Jessica Lammers, DNP, FNP-BC

• Clinical Psychologist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.