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NPI Code Detail

MEDICARE: TRACY DEEN

MEDICARE:   TRACY  DEEN
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
1235Z00000XSpeech-Language PathologistCA

General Provider Information

NPI Number : 1407291073
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY DEEN
Provider Business Mailing Address
First Line : 7840 MISSION CENTER CT STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1320
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7840 MISSION CENTER CT STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1320
Country : US
Telephone Number : 619-692-0622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2013
Last Update Date : 05/08/2013

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Directions to “ TRACY DEEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.