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NPI Code Detail

MEDICARE: TRACY JEANNINE CUTINO MA

MEDICARE: TRACY JEANNINE CUTINO MA
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
1106H00000XMarriage & Family TherapistLMFT# 47897CA

General Provider Information

NPI Number : 1740297902
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY JEANNINE CUTINO MA
Provider Business Mailing Address
First Line : 1141 LEVER BLVD
Second Line :
City : STOCKTON
State : CA
Zip : 95206-2855
Country : US
Telephone Number : 916-270-8169
Fax Number :
Provider Business Practice Location Address
First Line : 1141 LEVER BLVD
Second Line :
City : STOCKTON
State : CA
Zip : 95206-2855
Country : US
Telephone Number : 916-270-8169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 02/16/2024

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Directions to “ TRACY JEANNINE CUTINO MA” Practice Location

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