Kristen N Lake, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95007613 Issued in CA

Practice address

1620 E Roseville Pkwy
Ste 110
Roseville, CA 95661-3995

Phone

(916) 797-4715

Fax

(916) 797-4716

NPI assigned

Feb 15, 2017

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 CA

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

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Roseville, CA, CCN 057545
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klake396155@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment Care Compare group NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Fairfield, CA
  • NPI 1184859894

  Nurse Practitioner

  NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter North Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Roseville, CA
  • NPI 1770512535
  Care Compare affiliation

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702684800000",
    "number": "1720527336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "916-591-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E ROSEVILLE PKWY",
            "address_2": "STE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613995",
            "telephone_number": "916-797-4715",
            "fax_number": "916-797-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "KRISTEN",
        "middle_name": "N",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95140746",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry J. Lai, MD
• Sylvia Kao Lai, P.T.
• Thomas Lai, MD
• Chananid Laikijrung
• Emilia Laing
• Maribel Lalanne
• Srishti Laller, MD
• Joe Lam, PHARM. D.
• Mark Lam, MD
• Phuong Minh Lam

• Nurse Practitioner in Roseville, CA
• Providers in Roseville, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; 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.