MRS. TRACIE LEE KEPLER HOFFMAN (NPI# 1174843429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174843429 |
| Entity Type | Individual |
| Full Name | MRS. TRACIE LEE KEPLER HOFFMAN |
| Credential | MFT |
| Practice Address |
1761 Broadway St Suite 100 Vallejo CA 94589-2226 |
| Practice Telephone | 7076452700 |
| Practice Fax Number | 7076452181 |
| Mailing Telephone | 7076452700 |
| Mailing Fax Number | 7076452181 |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC47228 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00374007 | 05 |
| Street Address |
1761 BROADWAY ST SUITE 100 |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316901689 | Esker-d Ligon | Nurse Practitioner | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2006-04-13 |
| 1013452119 | Jamie Lutat | Occupational Therapist | 1761 Broadway St, Vallejo, CA 94589-2226 | 2016-12-27 |
| 1962864785 | The Permanente Medical Group | Health Maintenance Organization | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2016-03-22 |
| 1063824019 | Shasta Marie Ihorn | Psychologist | 1761 Broadway St, Ste 100, Vallejo, CA 94589-2226 | 2014-05-27 |
| 1851734495 | Jonah Raphael Paquette | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2013-04-13 |
| 1659616043 | Lisa Michelle Termansen | Audiologist | 1761 Broadway St, Suite 200, Vallejo, CA 94589-2226 | 2012-12-11 |
| 1609134824 | Carol Lynn Ferro | Psychiatry & Neurology | 1761 Broadway St, Ste 100, Vallejo, CA 94589-2226 | 2012-04-25 |
| 1902175763 | Tina Loan Kim Hua | Pharmacist | 1761 Broadway St, Vallejo, CA 94589-2226 | 2011-12-23 |
| 1164790432 | Kristin Lee Koperski | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2011-12-01 |
| 1760713713 | Jorge Belloso-curiel | Social Worker | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2010-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
| Find all providers in zip 94589 | ||||
| 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 |
|---|---|---|---|---|
| 1891264461 | Brian Emory Kellogg | Marriage & Family Therapist | 525 Oregon St., Php/iop, Vallejo, CA 94590 | 2018-11-13 |
| 1134633068 | Keshia R Ingram | Marriage & Family Therapist | 27 Chase St Apt A, Vallejo, CA 94590-7007 | 2017-11-30 |
| 1538512025 | Tristram King | Marriage & Family Therapist | 157 Sunnyglen Dr, Vallejo, CA 94591-7553 | 2016-07-20 |
| 1861858409 | Maurice Orr Travis | Marriage & Family Therapist | 236 Georgia St Ste 102, Vallejo, CA 94590-5962 | 2016-01-12 |
| 1346612942 | Jaime Betancur | Marriage & Family Therapist | 125 Corporate Pl # A, Vallejo, CA 94590-6968 | 2015-10-22 |
| 1215309711 | Michele Darnett Williams | Marriage & Family Therapist | 125 Corporate Pl Ste A, Vallejo, CA 94590-6968 | 2015-10-22 |
| 1922352715 | James Orlando | Marriage & Family Therapist | 935 York St, Vallejo, CA 94590-6254 | 2012-11-01 |
| 1225325376 | Evelyn Polk | Marriage & Family Therapist | 312 Georgia St, Suite #225, Vallejo, CA 94590-5964 | 2011-07-08 |
| 1285935478 | Michael Steven Jereb | Marriage & Family Therapist | 631 Tennesse St, Vallejo, CA 94590 | 2010-11-04 |
| 1366758294 | Irene Velasco | Marriage & Family Therapist | 1004 Marin St, Vallejo, CA 94590-5603 | 2010-08-30 |
| Find all providers in VALLEJO | ||||
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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.