TRACY CORNER (NPI# 1033258421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033258421 |
| Entity Type | Individual |
| Full Name | TRACY CORNER |
| Practice Address |
136 N San Mateo Dr Suite 101 San Mateo CA 94401-2777 |
| Mailing Address |
521 Rocky Way Pobox 620703 Woodside CA 94062-4021 |
| Practice Telephone | 6503730777 |
| Practice Fax Number | 6503730778 |
| Mailing Telephone | 6505999419 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT29823 | CA | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LPT | PT29823 | 01 |
| Street Address |
136 N SAN MATEO DR SUITE 101 |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94401-2777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265548390 | Medical Arts Obstetrics Gynecology | Obstetrics & Gynecology | 136 N San Mateo Dr, Suite 101, San Mateo, CA 94401-2779 | 2006-08-22 |
| 1417401068 | Michelle Christina Tsai Md Inc | Obstetrics & Gynecology | 136 N San Mateo Dr, Suite 101, San Mateo, CA 94401 | 2016-08-12 |
| 1811251242 | Roselyn Catherine Sandoval | Nurse Practitioner | 136 N San Mateo Dr, Suite 101, San Mateo, CA 94401-2777 | 2012-06-29 |
| 1972837573 | Jennifer Lee Prescott | Counselor | 136 N San Mateo Dr, Ste 101, San Mateo, CA 94401-2777 | 2009-09-29 |
| 1922231182 | Andrea Joy Feit | Counselor | 136 N San Mateo Dr, Ste 101, San Mateo, CA 94401-2777 | 2009-09-03 |
| 1386872919 | Deanna Lee Simmons | Counselor | 136 N San Mateo Dr, Ste 101, San Mateo, CA 94401-2777 | 2009-06-22 |
| 1477796282 | Judy Miller | Counselor | 136 N San Mateo Dr, Suite 101, San Mateo, CA 94401-2777 | 2009-04-08 |
| 1437396785 | Monteze Lee Gaines | Counselor | 136 N San Mateo Dr, Ste 101, San Mateo, CA 94401-2777 | 2009-01-08 |
| 1265696603 | Laura Carpenter | Counselor | 136 N San Mateo Dr, Suite 101, San Mateo, CA 94401-2777 | 2008-07-15 |
| 1558529065 | Sandra Beretta, Md, Inc | Obstetrics & Gynecology | 136 N San Mateo Dr, Suite 101, San Mateo, CA 94401-2777 | 2008-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800760 | Monica Marie Rivas | Behavior Technician | 429 Peninsula Avenue, San Mateo, CA 94401 | 2020-08-05 |
| 1609412865 | Cindy Toshiko Hedlin | Marriage & Family Therapist | 1117 S. B Street, Suite 9, San Mateo, CA 94401 | 2019-11-22 |
| 1750846655 | James Court Manor Inc. | Assisted Living Facility | 1316 James Court, San Mateo, CA 94401 | 2019-02-05 |
| 1467991778 | Maria Elena Lopez | Student in an Organized Health Care Education/Training Program | 325 Villa Terrace, San Mateo, CA 94401 | 2017-02-20 |
| 1487198339 | Johnie Pangelina | Behavioral Analyst | 242 Peninsula Ave, San Mateo, CA 94401 | 2016-12-12 |
| 1740736230 | Meredith Eileen Morgan | Dentist | 100 S. Ellsworth Av, #601, San Mateo, CA 94401 | 2016-08-25 |
| 1376998963 | Lior Tamir | Dentist | 800 B Street Suite #200, San Mateo, CA 94401 | 2016-05-02 |
| 1609233584 | Delicia Ortega | Behavioral Analyst | 424 Peninsula Avenue, San Mateo, CA 94401 | 2016-01-22 |
| 1396122388 | Ramy Salah | Internal Medicine | 50 S San Mateo Dr Ste 480, San Mateo, CA 94401 | 2015-04-29 |
| 1508255902 | Risso Counseling, Inc. | Marriage & Family Therapist | 120 North El Camino Real, San Mateo, CA 94401 | 2015-01-22 |
| Find all providers in zip 94401 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203592 | Leahann Vedella | Licensed Psychiatric Technician | 2398 Flatley Cir, Fairfield, CA 94533-8921 | 2020-10-23 |
| 1225635865 | Thalia I. Rochel | Licensed Psychiatric Technician | 450 E Temple St, Los Angeles, CA 90012-4022 | 2020-10-06 |
| 1427665090 | Egbert Tantiongco | Licensed Psychiatric Technician | 1460 E Willow St, Signal Hill, CA 90755-3549 | 2020-09-28 |
| 1114530250 | Heather Elizabeth Phillips | Licensed Psychiatric Technician | 4900 N Highway 99 Unit 68, Stockton, CA 95212-1007 | 2020-08-28 |
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1609491935 | Elisa Becerra | Licensed Psychiatric Technician | 745 Park St, Paso Robles, CA 93446-2834 | 2020-06-12 |
| 1518581099 | Theresa Lynn Stewart | Licensed Psychiatric Technician | 1110 Newport Way, Roseville, CA 95661-5315 | 2020-06-01 |
| 1093337511 | Christine Ann Scheuermann | Licensed Psychiatric Technician | 1447 Report Ave, Stockton, CA 95205-3030 | 2020-05-07 |
| 1477189512 | Sandra J Foshee | Licensed Psychiatric Technician | 48918 Mojave Dr, Morongo Valley, CA 92256-9243 | 2020-03-20 |
| 1376177725 | Chanel Christine Turpin | Licensed Psychiatric Technician | 450 Kings County Dr Ste 102, Hanford, CA 93230-5782 | 2020-02-25 |
| Find all providers with the same taxonomy | ||||
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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.