Healthcare Provider Details

I. General information

NPI: 1770989410
Provider Name (Legal Business Name): TRACY TOUSSAINT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 WEBSTER ST STE D
FAIRFIELD CA
94533-4935
US

IV. Provider business mailing address

1525 WEBSTER ST STE D
FAIRFIELD CA
94533-4935
US

V. Phone/Fax

Practice location:
  • Phone: 707-470-2888
  • Fax:
Mailing address:
  • Phone: 708-299-0079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95002385
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95002385
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number781827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: