TRACEY WILSON (NPI# 1538671359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538671359 |
| Entity Type | Individual |
| Full Name | TRACEY WILSON |
| Credential | RCFE |
| Practice Address |
639 S Gregory St San Diego CA 92113-2617 |
| Mailing Address |
864 Grand Ave # 802 San Diego CA 92109-3906 |
| Practice Telephone | 6196939080 |
| Practice Fax Number | 6193932177 |
| Mailing Telephone | 6193576472 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 376G00000X | Nursing Home Administrator | 6029334740 | CA | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RCFE ADMINISTRATOR CERTIFICATION | 6029334740 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 639 S Gregory St, San Diego, CA 921132617 | 6196939080 | 6193932177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720507759 | Tracey Linn Wilson | Case Manager/Care Coordinator | 300 Shelton Street, Chadron, NE 69337 | 2017-09-11 |
| 1750999728 | Tracey Wilson | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-07-16 |
| 1013576669 | Tracey Wilson | Behavioral Analyst | 12010 Linwood St, Detroit, MI 48206-1108 | 2019-06-07 |
| 1932693728 | Tracey Kersten Wilson | Nurse Anesthetist, Certified Registered | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2018-06-15 |
| 1205149358 | Tracey B Wilson | Pharmacist | 675 Woodbury Glassboro Rd, Sewell, NJ 08080-3733 | 2010-07-19 |
| 1487828885 | Tracey Wilson | Nurse Practitioner | 29 S Greene St, Baltimore, MD 21201-1504 | 2008-04-16 |
| 1902856735 | Tracey S Wilson | Urology | 619 19th St S, Birmingham, AL 35249-1900 | 2006-05-11 |
| Street Address |
639 S GREGORY ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92113-2617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305986 | Cynthia Alba | Nutritionist | 1809 National Ave., San Diego, CA 92113 | 2017-06-08 |
| 1184153983 | Jessy Milligan | Counselor | 4125 Alpha Street, San Diego, CA 92113 | 2017-06-06 |
| 1730557406 | Deborah Mary Malloy | Counselor | Jary Barreto, 2865 Logan Avenue, San Diego, CA 92113 | 2015-09-10 |
| 1104220912 | Imhotep Mustaqeem | Counselor | 3336 Steel Street, San Diego, CA 92113 | 2014-10-22 |
| 1831507300 | Olga Vasileva | Student in an Organized Health Care Education/Training Program | 2865 Logan Avenue, San Diego, CA 92113 | 2014-07-29 |
| 1477961951 | Angelica Quezada | Counselor | 32510 Newton Avenue B103, San Diego, CA 92113 | 2014-07-28 |
| 1477986750 | Anita Pena | Licensed Vocational Nurse | 604 Olivewood Ter, San Diego, CA 92113 | 2013-08-09 |
| 1134459399 | Susana Cabada | Technician, Other | 4031 Marine View Ave., San Diego, CA 92113 | 2010-01-11 |
| 1669595609 | Maria Emilia Siller | Registered Nurse | 3177a Oceanview Blvd, San Diego, AL 92113 | 2007-04-06 |
| 1710009691 | Maria Engracia Siordia | Licensed Vocational Nurse | 3177a Ocean View Blvd, San Diego, CA 92113 | 2007-04-04 |
| Find all providers in zip 92113 | ||||
| Taxonomy Code | 376G00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Nursing Home Administrator |
| An individual, often licensed by the state, who is responsible for the management of a nursing home. |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL, 1994, p. 552. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760210 | Vanessa Nunez | Nursing Home Administrator | 1697 Donax Ave, San Diego, CA 92154-1004 | 2020-11-08 |
| 1083144786 | Eva Rios Cac | Nursing Home Administrator | 8825 Stanwell St, San Diego, CA 92126-2813 | 2017-06-14 |
| 1508137993 | Susan Farmer | Nursing Home Administrator | 5137 Bellvale Ave, San Diego, CA 92117-4002 | 2012-01-18 |
| 1073136008 | Amanda Ladagana | Nursing Home Administrator | 4525 Mission Gorge Pl, San Diego, CA 92120-4106 | 2020-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637622 | Elizabeth Memoracion | Nursing Home Administrator | 2140 Ceres Ave, Chico, CA 95926-1403 | 2020-10-19 |
| 1659903037 | Noelia Garcia | Nursing Home Administrator | 2755 Thacker Dr, Corona, CA 92881-3634 | 2020-02-04 |
| 1164054557 | Romulo L Garcia | Nursing Home Administrator | 1540 Heartland Way, Corona, CA 92881-4179 | 2020-02-04 |
| 1902436058 | Musarrat Khan | Nursing Home Administrator | 14736 Willow Grove Pl, Moreno Valley, CA 92555-5746 | 2020-01-16 |
| 1295378818 | Yaninee Asawadilokchai | Nursing Home Administrator | 8191 Lambert Dr, Huntington Beach, CA 92647-4816 | 2019-10-27 |
| 1043861313 | Mary Grace P Trias | Nursing Home Administrator | 31485 Mandy Ct, Lake Elsinore, CA 92530-5124 | 2019-09-26 |
| 1982250635 | Lilibeth Mesa | Nursing Home Administrator | 8890 Harlow Ct, Elk Grove, CA 95624-3225 | 2019-08-16 |
| 1295380467 | Riverside Elite Advantage Care Home LLC | Nursing Home Administrator | 17085 Birch Hill Rd, Riverside, CA 92504-8823 | 2019-08-05 |
| 1275194284 | Kathy J Maghbouleh | Nursing Home Administrator | 26545 Avenida Deseo, Mission Viejo, CA 92691-3303 | 2019-06-21 |
| 1104388867 | Victoria Rehg | Nursing Home Administrator | 15535 China Rapids Dr, Red Bluff, CA 96080-9641 | 2019-04-02 |
| 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.