Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Susan Lake, PSYD

Individual provider Rehabilitation Counselor · NPI 1962784488

Susan Lake, PSYD is a Clinical Psychologist in San Rafael, California. Qualified in 2017, 9 years ago. Accepts Medicare assignment.

Years since qualifying
9
In the registry since
2011
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

1330 Lincoln Ave Ste 201
San Rafael, CA 94901-2142
Phone: (415) 459-5999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Counselor (primary) Taxonomy 225C00000X
Psychologist Taxonomy 103T00000X

Record details

NPI number1962784488
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedSeptember 10, 2011
Last updated in NPPESDecember 17, 2020
Certification dateNovember 16, 2020
Mailing address1330 Lincoln Ave Ste 201, San Rafael, CA 94901-2142

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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