Laura E Dietrich-Lake, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP10869 Issued in AZ

Practice address

4707 N 12TH St
Phoenix, AZ 85014-4009

Phone

(602) 344-2506

Fax

(602) 247-9506

NPI assigned

Dec 7, 2017

Last updated

Jan 27, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: laura.dietrich-lake@71082555932676.direct.elationemr.com
• Direct secure messaging: ldietrichlake139878@direct.valleywisehealth.org

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

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment Care Compare group NPD
• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1023174455
  Medicare reassignment NPD
• Kmtrask, PLLC

  • Nurse Practitioner
  • Gilbert, AZ
  • NPI 1518413962
  Medicare reassignment NPD
• Maricopa County Special Health Care District

  dba Valleywise Health

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1073576740
  Medicare reassignment NPD
• Partners in Recovery, LLC

  • Adult Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1922232925
  Medicare reassignment NPD
• District Medical Group, Inc

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1124251020
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1316009145
  NPD
• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1609939214
  NPD
• Maricopa County Special Health Care District

  dba Maricopa Special Health Care District

  • Adult Mental Health Clinic/Center
  • Mesa, AZ
  • NPI 1003273855
  NPD
• Maricopa County Special Health Care District

  dba Maricopa Integrated Heatlh

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1306265145
  NPD
• Partners in Recovery, LLC

  dba ACT Metro IHH

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1306698436
  NPD

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1639684046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850144009",
            "telephone_number": "602-344-2506",
            "fax_number": "602-247-9506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 S Val Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977323",
            "country_code": "US",
            "telephone_number": "480-728-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3555 S Val Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977323",
            "country_code": "US",
            "telephone_number": "480-728-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETRICH-LAKE",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10869",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Dierks
• Diersing Audiology Corp PC (Comprehensive Mobile Care Dental Group)
• Lindsey Anne Dies, LPC
• Suzanne Diesel
• Timothy Ross Diestelkamp, MD
• Aryanna Dietz
• Mark Dietzgen, NMD
• Haley M Dietzman
• Ladon Dieu, RN
• Karen J Difrancesco, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.