Individual provider Active NPI

Lacy Pack

  • Licensed Psychiatric Technician
  • Yuba City, CA
National Provider Identifier
1992244552
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
Practice address
1965 Live Oak Blvd
Yuba City, CA 95991-8850
Phone
(530) 822-7200
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Licensed Psychiatric Technician 167G00000X 41444 CA
Licensed Psychiatric Technician 167G00000X Primary

Addresses

Primary practice location

1965 Live Oak Blvd
Yuba City, CA 95991-8850

Mailing address

1965 Live Oak Blvd
Yuba City, CA 95991-8850
Phone (530) 822-7200

Other practice location 1

2975 McMillan Ave Ste 164
San Luis Obispo, CA 93401-6768
Phone (805) 439-4890

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

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1992244552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959918850",
            "telephone_number": "530-822-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959918850",
            "telephone_number": "530-822-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2975 McMillan Ave Ste 164",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934016768",
            "country_code": "US",
            "telephone_number": "805-439-4890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACK",
        "first_name": "LACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "41444",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.