MEDICARE: TRACI DUNLAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	129119	CA

General Provider Information

NPI Number	:	1255092094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI DUNLAP

Provider Business Mailing Address
First Line	:	PO BOX 262
Second Line	:
City	:	GRIDLEY
State	:	CA
Zip	:	95948-0262
Country	:	US
Telephone Number	:	530-632-1458
Fax Number	:

Provider Business Practice Location Address
First Line	:	1445 VETERANS MEMORIAL CIR STE B
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95993-3011
Country	:	US
Telephone Number	:	530-822-7513
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	12/03/2025

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Directions to “ TRACI DUNLAP ” Practice Location

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