Stephanie J Lake, CATC

Primary specialty

SpecialistTaxonomy code 174400000X

License

CATC #091698 Issued in CA

Practice address

One Shields Ave
UC Davis Student Health and Couseling Services
Davis, CA 95616

Phone

(530) 752-6334

Fax

(530) 752-4252

NPI assigned

Jun 22, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1891058947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE SHIELDS AVE",
            "address_2": "UC DAVIS STUDENT HEALTH AND COUSELING SERVICES",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-752-6334",
            "fax_number": "530-752-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE SHIELDS AVE",
            "address_2": "UC DAVIS STUDENT HEALTH AND COUSELING SERVICES",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-752-6334",
            "fax_number": "530-752-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "CATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "CATC #091698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt S. Kusserow, MD
• Gayle Kyhos
• Marie Elise La Croix
• Sherrie Ladegast, F.N.P.
• Kristina W Lai, MPH
• Renuka Lakshminarayanan, M.D.
• Angeline-Diep Ngoc Lam, D.D.S.
• Julie Ngoc Lam
• Parie E. Lambert, CNM
• Simone Lance, CNM

• Specialist in Davis, CA
• Providers in Davis, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.