Individual provider Active NPI

Lynette Thorlakson

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1619062460
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 46168 Issued in CA
Practice address
9343 Tech Center Dr
2ND Floor
Sacramento, CA 95826-2563
Phone
(916) 388-6400
Fax
(916) 649-5178
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 46168 CA Primary

Addresses

Primary practice location

9343 Tech Center Dr
2ND Floor
Sacramento, CA 95826-2563

Mailing address

9343 Tech Center Dr.
2ND Floor
Sacramento, CA 95826-2454
Phone (916) 388-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240201003603 WA Practitioner - Marriage and Family Therapist 1557714854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC 46168CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2024 Accepting new patients

Locations

13451 SE 36th St
Bellevue, WA 98006
Phone (425) 562-1316

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 2

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1619062460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9343 TECH CENTER DR.",
            "address_2": "2ND FLOOR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262454",
            "telephone_number": "916-388-6400",
            "fax_number": "916-649-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9343 TECH CENTER DR",
            "address_2": "2ND FLOOR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262563",
            "telephone_number": "916-388-6400",
            "fax_number": "916-649-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORLAKSON",
        "first_name": "LYNETTE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 46168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.