KIMBERLY ANN LACY
NPI 1306220157
Marriage & Family Therapist in San Leandro, CA
About Kimberly Ann Lacy NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY ANN LACY (NPI 1306220157) is an individual marriage & family therapist in San Leandro, California, licensed in California (123204) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimberly Ann Lacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Lacy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Redwood City, CA 94063
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN LEANDRO, CA 94578
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Lacy's NPI number?
The NPI number for Kimberly Lacy is 1306220157. It was assigned to this individual provider in the NPPES registry on July 10, 2015.
Where is Kimberly Lacy located?
Kimberly Lacy practices at 2275 Arlington Dr, San Leandro, CA 94578. The listed phone number is (510) 317-1444.
What is Kimberly Lacy's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Kimberly Lacy enrolled in Medicare?
Yes. Kimberly Lacy is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kimberly Lacy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Lacy reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Lacy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kimberly Lacy was last updated on June 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kimberly Ann Lacy · NPI 1306220157
Marriage & Family Therapist provider in San Leandro, California. Individual provider, active in the CMS NPPES registry since July 10, 2015.
## Identity
- **NPI:** 1306220157 (Entity type: Individual)
- **Enumerated:** July 10, 2015
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 123204 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2275 ARLINGTON DR, San Leandro, CA 94578-1132
- **Phone:** (510) 317-1444
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1639252604, Redwood City, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 16, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1306220157) · Data from the CMS NPPES public registry.