Active NPI
Lisa Ann Dickinson, LMFT
- Marriage & Family Therapist
- El Dorado Hills, CA
National Provider Identifier
1407108970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 52228
- Practice address
- 4993 Golden Foothill Pkwy Ste 6
El Dorado Hills, CA 95762-9642 - Phone
- (805) 479-1148
- NPI assigned
- Oct 9, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 52228 | CA | Primary |
Addresses
Primary practice location
4993 Golden Foothill Pkwy Ste 6
El Dorado Hills, CA 95762-9642
Mailing address
4993 Golden Foothill Parkway
Suite 6
El Dorado Hills, CA 95762
Phone (805) 479-1148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 52228 | CA | MD | Marriage & Family Therapist |
| 52228 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1407108970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4993 GOLDEN FOOTHILL PARKWAY",
"address_2": "SUITE 6",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "95762",
"telephone_number": "805-479-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4993 GOLDEN FOOTHILL PKWY STE 6",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629642",
"telephone_number": "805-479-1148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKINSON",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 52228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.