Healthcare Provider Details

I. General information

NPI: 1144114604
Provider Name (Legal Business Name): BTC - TRACY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 S TRACY BLVD STE 108
TRACY CA
95377-8105
US

IV. Provider business mailing address

4600 S TRACY BLVD STE 108
TRACY CA
95377-8105
US

V. Phone/Fax

Practice location:
  • Phone: 818-726-4196
  • Fax:
Mailing address:
  • Phone: 510-722-1069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GARMEN A WOO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 510-722-1069