DR. TRACY LYNN CARLIS (NPI# 1730225640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730225640 |
| Entity Type | Individual |
| Full Name | DR. TRACY LYNN CARLIS |
| Credential | PHD |
| Practice Address |
5000 Hayvenhurst Ave Encino CA 91436-1115 |
| Practice Telephone | 8187130508 |
| Practice Fax Number | 8187038050 |
| Mailing Telephone | 8187130508 |
| Mailing Fax Number | 8187038050 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | PSY16888 | CA | Other Service Providers |
| Street Address |
5000 HAYVENHURST AVE |
| City | ENCINO |
| State | CA |
| Zip Code | 91436-1115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801405014 | Find Your Balance, Center for Growth & Change Inc. | Marriage & Family Therapist | 15720 Ventura Blvd Suite 603, Encino, CA 91436 | 2020-07-24 |
| 1396214482 | Maria Guadalupe Cruz | Behavior Technician | 16500 Ventura Blvd # 414, Encino, CA 91436 | 2018-11-19 |
| 1699277186 | Rodolfo Alavez Jimenez | Behavior Technician | 16500 Ventura Blvd., Suite 414, Encino, CA 91436 | 2018-03-01 |
| 1750891503 | Robert James Kim-farley | Preventive Medicine | 4037 Rogen Drive, Encino, CA 91436 | 2017-10-06 |
| 1528577871 | Julia Szpakiewicz | Marriage & Family Therapist | 16550 Ventura Blvd 318, Encino, CA 91436 | 2017-09-28 |
| 1457875452 | Jeffrey Proniloff | Dentist | 16680 Ashley Oaks, Encino, CA 91436 | 2017-08-01 |
| 1114449592 | Loren Lizeth Huerta | Specialist/Technologist | 16500 Ventura Blvd #414, Encino, CA 91436 | 2017-07-07 |
| 1538619838 | Gilbert Torres Jr. | Physical Therapist | 16260 Ventura Blvd # 600, Encino Medical Tower, Encino, CA 91436 | 2016-10-11 |
| 1417313529 | Nancy L Reynolds | Marriage & Family Therapist | 16055 Ventura Blvd #409, Encino, CA 91436 | 2016-01-05 |
| 1457716748 | Salvador Salgado | Behavioral Analyst | 16500 Ventura Blvd. Suite 414, Encino, CA 91436 | 2015-12-31 |
| Find all providers in zip 91436 | ||||
| Taxonomy Code | 170100000X |
| Grouping | Other Service Providers |
| Classification | Medical Genetics, Ph.D. Medical Genetics |
| A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
| Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073132767 | Deaunne Denmark | Medical Genetics, Ph.D. Medical Genetics | 373 S Monroe St Ste 202, San Jose, CA 95128-5126 | 2020-04-13 |
| 1578012498 | Andre Turner | Medical Genetics, Ph.D. Medical Genetics | 120 N 13th Ave Apt D, Upland, CA 91786-5584 | 2016-10-04 |
| 1568918712 | Plbc Medical Group, Inc | Medical Genetics, Ph.D. Medical Genetics | 8900 Wilshire Blvd, Suite 300, Beverly Hills, CA 90211 | 2016-08-28 |
| 1952856205 | Sana Alexandrovna Nodelman | Medical Genetics, Ph.D. Medical Genetics | 7224 Hillside Ave, 26, Los Angeles, CA 90046-2359 | 2016-08-16 |
| 1124496690 | Renz Lorenz Gatchalian | Medical Genetics, Ph.D. Medical Genetics | 2416 W Tennyson Rd Apt 308, Hayward, CA 94545-4158 | 2015-09-14 |
| 1285902080 | Gail Humble | Medical Genetics, Ph.D. Medical Genetics | 101 N PCh Hwy Ste 102, Redondo Beach, CA 90277-3149 | 2011-12-07 |
| 1598040784 | Maternal Fetal Medicine Medical Group of Southern California | Medical Genetics, Ph.D. Medical Genetics | 207 S. Santa Anita Street, Suite 338, Sangabriel, CA 91776-1160 | 2011-10-19 |
| 1518129048 | Dr Brian F Topkis A Medical Group | Medical Genetics, Ph.D. Medical Genetics | 2021 Mt Diablo Blvd #100, Walnut Creek, CA 94596 | 2008-06-26 |
| 1396946224 | Ramiro Futalan Sr. | Medical Genetics, Ph.D. Medical Genetics | 8292 Telegraph Rd, Downey, CA 90240-2277 | 2007-05-29 |
| 1518178110 | Fatolah Ferdowsian | Medical Genetics, Ph.D. Medical Genetics | 8845 E Crestview Ln, Anaheim, CA 92808-1664 | 2007-05-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. TRACY LYNN CARLIS.
| 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.