MEDICARE: LAUREN DIBBLE MA, LMFT 123427

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LMFT123427	CA
2	106H00000X	Marriage & Family Therapist	IMF101932	CA

General Provider Information

NPI Number	:	1780194381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN DIBBLE MA, LMFT 123427

Provider Business Mailing Address
First Line	:	924 57TH ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3328
Country	:	US
Telephone Number	:	916-287-8876
Fax Number	:	916-287-8876

Provider Business Practice Location Address
First Line	:	924 57TH ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3328
Country	:	US
Telephone Number	:	916-287-8876
Fax Number	:	916-287-8876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	11/21/2025

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