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NPI Code Detail

MEDICARE: MS. TRACI AILEEN PAPOFF

MEDICARE: MS. TRACI AILEEN PAPOFF
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
1101Y00000XCounselor
2171M00000XCase Manager/Care CoordinatorCA

General Provider Information

NPI Number : 1952770786
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACI AILEEN PAPOFF
Provider Business Mailing Address
First Line : 910 S GARFIELD ST APT 10
Second Line :
City : LODI
State : CA
Zip : 95240-5418
Country : US
Telephone Number : 360-878-3694
Fax Number :
Provider Business Practice Location Address
First Line : 3628 MADISON AVE STE 67AND10
Second Line :
City : NORTH HIGHLANDS
State : CA
Zip : 95660-5069
Country : US
Telephone Number : 916-388-3231
Fax Number : 916-388-3232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2015
Last Update Date : 12/12/2022

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