Healthcare Provider Details

I. General information

NPI: 1609908979
Provider Name (Legal Business Name): TRACY ANN CALDEIRA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6285 E SPRING ST # 539
LONG BEACH CA
90808-4020
US

IV. Provider business mailing address

2835 NIPOMO AVE
LONG BEACH CA
90815-1502
US

V. Phone/Fax

Practice location:
  • Phone: 562-310-7685
  • Fax: --
Mailing address:
  • Phone: 562-310-7685
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY16318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: