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General NPI Number Information
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NPI Number | 1295249225
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Entity Type | Individual
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Provider Name | TRACY LE HENRY MSN, FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 17075 DEVONSHIRE ST STE 204
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City | NORTHRIDGE
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State | CA
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Zip | 91325-5408
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Country | US
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Telephone | 818-368-8929
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Fax |
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Provider Business Mailing Address
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Address Line | 620 HOUSEMAN ST
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City | LA CANADA FLINTRIDGE
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State | CA
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Zip | 91011-2638
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Country | US
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Telephone | 310-902-5364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 65007673
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95007673
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License Number State | CA
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