Individual provider Active NPI

Ellen Patricia Lacter, PH.D.

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1447274881
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC17912 Issued in CA
Practice address
3505 Camino del Rio S
Suite 212
San Diego, CA 92108-4002
Phone
(619) 584-7737
Fax
(858) 549-4202
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY9382 CA
Marriage & Family Therapist 106H00000X MFC17912 CA Primary

Addresses

Primary practice location

3505 Camino del Rio S
Suite 212
San Diego, CA 92108-4002

Mailing address

3505 Camino del Rio S
Suite 212
San Diego, CA 92108-4002
Phone (619) 584-7737

Other identifiers 2

IdentifierTypeStateIssuer
076585OtherCAMANAGED HEALTH NETWORK
PR0093820MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000740 CA Practitioner - Clinical Psychologist 8022096478 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3505 Camino del Rio S
San Diego, CA 92108-4016
Phone (619) 584-7737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC17912CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sofie PHD Psychology Co PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1447274881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 CAMINO DEL RIO S",
            "address_2": "SUITE 212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084002",
            "telephone_number": "619-584-7737",
            "fax_number": "858-549-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 CAMINO DEL RIO S",
            "address_2": "SUITE 212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084002",
            "telephone_number": "619-584-7737",
            "fax_number": "858-549-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACTER",
        "first_name": "ELLEN",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9382",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC17912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "076585",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PR0093820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.