TRACEY CLARK (NPI# 1154703015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154703015 |
| Entity Type | Individual |
| Full Name | TRACEY CLARK |
| Credential | M.A., LMFT |
| Practice Address |
1457 E Chapman Ave Fullerton CA 92831-3912 |
| Practice Telephone | 7146555371 |
| Mailing Telephone | 7146555371 |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2016-12-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 53834 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942830047 | Tracey Clark | Technician | 1118 46th St Ne Apt 1b, Washington, DC 20019-3844 | 2020-01-17 |
| 1215479415 | Tracey Clark | Counselor | 65 Waltham Ave, Manitou Springs, CO 80829-1612 | 2016-11-06 |
| 1437314127 | Tracey Durkovich Clark | Ophthalmology | 1 Ridgewood Drive, Bangor, ME 04401 | 2008-07-23 |
| 1396967956 | Tracey Elizabeth Clark | Social Worker | 775 Dent Road, Roanoke, VA 24019-4116 | 2007-05-03 |
| 1912402017 | Tracey Lyn Clark | Social Worker | 500 Barfield Dr, Hastings, MI 49058-9018 | 2018-03-29 |
| 1720449556 | Tracey Clark | Specialist | 2201 Main St, #1200, Dallas, TX 75201-4327 | 2016-03-07 |
| 1568413953 | Tracey Ann Clark | Pediatrics | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2006-05-12 |
| Street Address |
1457 E CHAPMAN AVE |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-3912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487084869 | Diana Elizabeth Martinez | Marriage & Family Therapist | 1457 E Chapman Ave, Fullerton, CA 92831-3912 | 2013-11-20 |
| 1235676339 | Traci Medeiros-bagan | Marriage & Family Therapist | 1457 E Chapman Ave, Fullerton, CA 92831-3912 | 2017-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831714047 | Jessie Lynn Brucki | Marriage & Family Therapist | 2016 E Chapman Ave Ste 111, Fullerton, CA 92831-4191 | 2020-06-12 |
| 1427671411 | Mieka K Bledsoe | Marriage & Family Therapist | 1800 Brea Blvd # A4, Fullerton, CA 92835-3934 | 2020-05-25 |
| 1548800923 | Taylor Marie Ramsey | Marriage & Family Therapist | 2601 E Chapman Ave Ste 11, Fullerton, CA 92831-3737 | 2020-01-13 |
| 1699310375 | Elizabeth Darrigo-patrick | Marriage & Family Therapist | 2701 E Chapman Ave Ste 203, Fullerton, CA 92831-3751 | 2019-11-17 |
| 1861966087 | Kimson F Johnston | Marriage & Family Therapist | 1370 Brea Blvd Suite 210, Fullerton, CA 92835 | 2019-01-22 |
| 1427537414 | Kevin Downing | Marriage & Family Therapist | 1370 Brea Blvd Ste 245, Fullerton, CA 92835-4173 | 2018-08-09 |
| 1659872919 | Anthony James Arneson | Marriage & Family Therapist | 120 N Lawrence, Fullerton, CA 92832 | 2018-02-22 |
| 1750836573 | Caitlin Williams | Marriage & Family Therapist | 609 N Harbor Blvd, Fullerton, CA 92832-1517 | 2016-08-22 |
| 1376931998 | Maryam Rasouli | Marriage & Family Therapist | 2601 E Chapman Ave Ste 102, Fullerton, CA 92831-3737 | 2015-01-05 |
| 1003232547 | Lighthouse Family Counseling Inc. | Marriage & Family Therapist | 1440 N. Harbor Blvd., Suite 908, Fullerton, CA 92838 | 2014-03-07 |
| Find all providers in FULLERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.