Individual provider Active NPI

Lisa Ann Kijak

  • Marriage & Family Therapist
  • Laguna Hills, CA
National Provider Identifier
1902518350
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129347 Issued in CA
Practice address
23521 Paseo de Valencia Ste B5
Laguna Hills, CA 92653-3125
Phone
(949) 540-0170
NPI assigned
Dec 16, 2022
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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 129347 CA Primary

Addresses

Primary practice location

23521 Paseo de Valencia Ste B5
Laguna Hills, CA 92653-3125

Mailing address

23521 Paseo de Valencia Ste B5
Laguna Hills, CA 92653-3125
Phone (949) 540-0170

Other practice location 1

4281 Katella Ave Ste 117
Los Alamitos, CA 90720-3590
Phone (562) 596-0050

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
129347CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
S.a.G.E. Holistic Health & Wellness Center Marriage & Family Therapist PastSince Dec 1, 2022 Accepting new patients
Twin Town Corporation PastSince Jan 4, 2026 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1902518350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA STE B5",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533125",
            "telephone_number": "949-540-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA STE B5",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533125",
            "telephone_number": "949-540-0170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4281 Katella Ave Ste 117",
            "address_purpose": "LOCATION",
            "city": "Los Alamitos",
            "state": "CA",
            "postal_code": "907203590",
            "country_code": "US",
            "telephone_number": "562-596-0050",
            "fax_number": "562-596-0058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIJAK",
        "first_name": "LISA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.