Individual provider Active NPI

Lien Kim Lac

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1669838090
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111866 Issued in CA
Practice address
915 Highland Pointe Dr Ste 250
Roseville, CA 95678
Phone
(510) 599-8139
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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 111866 CA Primary

Addresses

Primary practice location

915 Highland Pointe Dr Ste 250
Roseville, CA 95678

Mailing address

910 Pleasant Grove Blvd Ste 120-182
Roseville, CA 95678-6193
Phone (510) 599-8139

Other practice location 1

915 Highland Pointe Dr Ste 250
Roseville, CA 95678
Phone (510) 599-8139

Other practice location 2

915 Highland Pointe Dr Ste 250
Roseville, CA 95678
Phone (510) 599-8139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111866CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Lemon Therapy CurrentSince Sep 23, 2024 Accepting new patients
Lien Lac LMFT Marriage & Family Therapist CurrentSince Nov 17, 2019 Accepting new patients
Endurance- a Sports and Psychology Center, Inc. Marriage & Family Therapist Past Accepting new patients

Locations

1700 Eureka Rd
Ste 155
Roseville, CA 95661
Phone (916) 276-0823

915 Highland Pointe Dr
Ste 250
Roseville, CA 95678
Phone (530) 713-4306

428 Vernon St
Roseville, CA 95678
Phone (916) 270-4199

Organizations & group practices 3

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": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1669838090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 PLEASANT GROVE BLVD STE 120-182",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786193",
            "telephone_number": "510-599-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND POINTE DR STE 250",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95678",
            "telephone_number": "510-599-8139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Highland Pointe Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "95678",
            "country_code": "US",
            "telephone_number": "510-599-8139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 Highland Pointe Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "95678",
            "country_code": "US",
            "telephone_number": "510-599-8139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAC",
        "first_name": "LIEN",
        "middle_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.