TRACIE LORRAINE GADLER (NPI# 1063828671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063828671 |
| Entity Type | Individual |
| Full Name | TRACIE LORRAINE GADLER |
| Other Name | TRACIE BLAKE |
| Credential | NP |
| Practice Address |
4077 Fifth Ave San Diego CA 92103-2105 |
| Practice Telephone | 6195653892 |
| Mailing Telephone | 6195653892 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2016-01-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 613828 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16862 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4077 FIFTH AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306808464 | Eric Dahms | Internal Medicine | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2006-04-04 |
| 1528672532 | Orlando Manzano | Nurse Practitioner | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-09-07 |
| 1518570167 | Lindsay Gumm | Social Worker | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-08-24 |
| 1821608811 | Tammy V Pham, M.d., Apc | Obstetrics & Gynecology | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-08-04 |
| 1891310538 | Jordan Ray Noble | Nurse Practitioner | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-06-09 |
| 1861014714 | Merril Lindner | Dietetic Technician, Registered | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-14 |
| 1215559042 | Kevin Kavanagh | Pharmacist | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-14 |
| 1942821525 | Page Staley Hope Moore | Occupational Therapist | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-05 |
| 1316568033 | Brent Conrad Beckner | Pharmacist | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-04 |
| 1306474101 | Kate Hebert Pool | Student in an Organized Health Care Education/Training Program | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203097 | Rebecca Dolores Garcia | Nurse Practitioner | 2440 Curlew St, San Diego, CA 92101-1327 | 2020-10-20 |
| 1003415472 | Ryanleo Flores | Nurse Practitioner | 2017 1st Avenue, Suite 301, San Diego, CA 92101 | 2020-10-18 |
| 1083226245 | Allison Floyd | Nurse Practitioner | 3652 Texas St, San Diego, CA 92104-4044 | 2020-08-19 |
| 1386255248 | Helen Hyeyoung Hong | Nurse Practitioner | 5140 Caminito Exquisito, San Diego, CA 92130-2852 | 2020-08-13 |
| 1134747595 | Dawn Elyse Rose | Nurse Practitioner | 8260 Mira Mesa Blvd Ste A, San Diego, CA 92126-2662 | 2020-07-10 |
| 1982232591 | John Meier | Nurse Practitioner | 3745 Riviera Dr Apt 10, San Diego, CA 92109-6661 | 2020-03-30 |
| 1013543008 | Alex Choi Mara | Nurse Practitioner | 5248 Zephyr Ln Unit 24, San Diego, CA 92120-2749 | 2020-03-21 |
| 1669005021 | Katlyn Ann Hartman | Nurse Practitioner | 1951 4th Ave, San Diego, CA 92101-2374 | 2020-02-13 |
| 1245876101 | Katherine Baber | Nurse Practitioner | 3671 Fifth Ave, San Diego, CA 92103-4218 | 2019-11-25 |
| 1922644095 | Taiko Harris | Nurse Practitioner | 13592 Bolero Way, San Diego, CA 92130-7006 | 2019-11-22 |
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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.