Individual provider Active NPI

James Henry Lake, M.D.

  • Psychosomatic Medicine Physician
  • Monterey, CA
National Provider Identifier
1871794404
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
G77237 Issued in CA
Practice address
1015 Cass St
Suite 8
Monterey, CA 93940-4536
Phone
(831) 644-9125
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X G77237 CA Primary

Addresses

Primary practice location

1015 Cass St
Suite 8
Monterey, CA 93940-4536

Mailing address

1015 Cass St
Suite 8
Monterey, CA 93940-4536
Phone (831) 644-9125

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111003000693 CA Practitioner - Psychiatry 7315119906 Reassigns benefits to 2 organizations
Practice locations: Monterey, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey Behavioral Health CurrentSince Nov 12, 2025 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Apr 17, 2023 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871794404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 CASS ST",
            "address_2": "SUITE 8",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404536",
            "telephone_number": "831-644-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CASS ST",
            "address_2": "SUITE 8",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404536",
            "telephone_number": "831-644-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JAMES",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "CA",
            "license": "G77237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.