MRS. TRACY JEANNETTE DICKERSON (NPI# 1124334149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124334149 |
| Entity Type | Individual |
| Full Name | MRS. TRACY JEANNETTE DICKERSON |
| Credential | B.A |
| Practice Address |
350 Kresge Lane Sparks NV 89431 |
| Practice Telephone | 7753599200 |
| Mailing Telephone | 7753599200 |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers | ||
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568983112 | Tracy Dickerson | Marriage & Family Therapist | 8170 Beverly Blvd Ste 207, Los Angeles, CA 90048-4532 | 2017-07-05 |
| 1629391040 | Tracy Dickerson | Massage Therapist | 1802 Eagle Harbor Ln Ne, Bainbridge Island, WA 98110-2142 | 2010-03-12 |
| 1063042224 | Tracy L Dickerson | Case Manager/Care Coordinator | 103 2nd Ave, Chesapeake, OH 45619-1134 | 2020-01-16 |
| 1356570634 | Tracy Dickerson | Physician Assistant | 2100 Dorchester Ave, Dept. of Surgery, Dorchester Center, MA 02124-5615 | 2009-07-08 |
| 1942453113 | Tracy Dickerson | Nurse Anesthetist, Certified Registered | 2801 Bay Park Dr, Oregon, OH 43616-4920 | 2008-10-31 |
| Street Address |
350 KRESGE LANE |
| City | SPARKS |
| State | NV |
| Zip Code | 89431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609183250 | Adam Joseph Welchert | Specialist | 350 Kresge Lane, Sparks, NV 89431 | 2010-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053958033 | Jerome Johnson II | Behavioral Analyst | 3115 Saltern Way, Sparks, NV 89431 | 2019-12-09 |
| 1528520640 | Dynisha Bernee Richardson | Technician, Other | 616 Victorian Ave, Sparks, NV 89431 | 2019-04-05 |
| 1902376494 | Avalon Care Center-va Reno, LLC | Skilled Nursing Facility | 36 Battle Born Way, Sparks, NV 89431 | 2018-11-28 |
| 1669964128 | Abraham A Arellano | Behavioral Analyst | 2005 Probasco Way, Sparks, NV 89431 | 2018-05-31 |
| 1003335399 | Carresa Greer | Counselor | 390 Freeport Blvd #3, Sparks, NV 89431 | 2017-09-18 |
| 1689197444 | Fred Blauth Jr. | Counselor | 2105 Sullivan Ln, Sparks, NV 89431 | 2017-07-24 |
| 1548719255 | Adolescent Treatment Center | Community Based Residential Treatment Facility, Mental Illness | 480 Galetti Way, Sparks, NV 89431 | 2016-09-23 |
| 1124478862 | Kristina Schneider | Behavioral Analyst | 3230 Wedekind Rd, 50, Sparks, NV 89431 | 2016-06-14 |
| 1336506898 | Rikki Texter | Occupational Therapy Assistant | 1025 Robert Lane, Sparks, NV 89431 | 2016-01-28 |
| 1851760177 | Elizabeth Ojeda | Counselor | 490 Galletti Way, Building 8c, Sparks, NV 89431 | 2015-09-16 |
| Find all providers in zip 89431 | ||||
| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577624 | Caitlyn Triplett | Psychologist | 896 Glen Molly Dr, Sparks, NV 89434-3467 | 2020-10-28 |
| 1174082127 | Jocelyn Garcia | Psychologist | 7014 Voyage Dr, Sparks, NV 89436-5429 | 2019-03-19 |
| 1396157780 | Krystal Guajardo | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2014-05-20 |
| 1356603039 | Carlos Eduardo Perez | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2012-06-08 |
| 1063786275 | Nikia L Johnson | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2012-03-06 |
| 1770861353 | Monica C. Leyva | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2011-07-29 |
| 1710265772 | Abram Ray Minnitte | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2011-07-25 |
| 1467730507 | Andrew Granata | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2011-07-22 |
| 1790089563 | Jennifer Michelle Miron | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2011-01-07 |
| 1093019846 | Keiland Maurice Henderson | Psychologist | 350 Kresge Ln, Sparks, NV 89431-6435 | 2011-01-07 |
| Find all providers in SPARKS | ||||
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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.