Healthcare Provider Details

I. General information

NPI: 1023450301
Provider Name (Legal Business Name): JACKY LAU LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 HOPE ST STE 350
SOUTH PASADENA CA
91030-2658
US

IV. Provider business mailing address

1605 HOPE ST STE 350
SOUTH PASADENA CA
91030-2658
US

V. Phone/Fax

Practice location:
  • Phone: 626-701-4249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number101550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: