Individual provider Active NPI

Lauren Lynch

  • Psychiatric/Mental Health Nurse Practitioner
  • El Cajon, CA
National Provider Identifier
1982590287
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95037620 Issued in CA
Practice address
1240 Broadway
El Cajon, CA 92021-4994
Phone
(619) 841-1310
NPI assigned
Jun 16, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR26140300 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95037620 CA Primary
Critical Care Medicine Registered Nurse 163WC0200X 820234-01 NY
Registered Nurse 163W00000X L1-0073853 DE
Registered Nurse 163W00000X RN95333845 CA
Registered Nurse 163W00000X RN788149 PA

Addresses

Primary practice location

1240 Broadway
El Cajon, CA 92021-4994

Mailing address

1240 Broadway
El Cajon, CA 92021-4994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20260105002687 TX Practitioner - Nurse Practitioner 6608362181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive PathwayGroup PAC ID 4284081639, 12 clinicians

Practice addresses (Care Compare)

1240 Broadway
El Cajon, CA 92021-4994
Phone (619) 841-1310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN95333845CAMDRegistered Nurse
L1-0073853DEMDRegistered Nurse
26NR26140300NJMDRegistered Nurse
RN788149PAMDRegistered Nurse
820234-01NYMDCritical Care Medicine Registered Nurse
95037620CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Pathway CurrentSince Dec 8, 2025 Accepting new patients

Locations

1240 Broadway
El Cajon, CA 92021
Phone (619) 841-1310

6650 Gunpark Dr
Ste 100
Boulder, CO 80301

Organizations & group practices 1

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1982590287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920214994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920214994",
            "telephone_number": "619-841-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR26140300",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95037620",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "820234-01",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0073853",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95333845",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN788149",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.