| Doctor Name: | DR. KAREN A. LAKE |
| NPI Number: | 1184026692 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PSY26579 |
| Business Practice Address: | 27068 La Paz Rd Suite 237 Aliso Viejo, CA - 926563041 |
| Business Phone Number: | 9492952269 |
| Business Fax Number: | |
| Mailing Address: | 23592 Windsong Apt 37b, ALISO VIEJO |
| State: | CA |
| Postal Code: | 926562346 |
| Phone Number: | 9492952269 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2014 |
| NPI Last Update Date: | 09/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY26579 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |