Tracie Danielle Harvey, M.D.
Individual provider Active NPI Child & Adolescent Psychiatry Physician · Sanger, CA
NPI 1013970037 · NPPES record last updated Jun 15, 2020
Key facts
- NPI
- 1013970037
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- G83052 (CA)
- Practice address
- 225 Academy Ave
Sanger, CA 93657-2128 - Phone
- (559) 875-7705
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of California, Geffen School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hiawatha Harris MD Inc.
Practice addresses (Care Compare)
5674 Stoneridge Dr
Suite 205
Pleasanton, CA 94588-8585
Phone (925) 520-0005
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050302000807 | CA | Practitioner - Psychiatry | 0345293262 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hiawatha Harris, M.D., Inc. | Current |
Accepting new patients | |
| Hiawatha Harris, Corporation | Current |
Accepting new patients | |
| Pacific Clinics | Past | Accepting new patients | |
| Tracie D Harvey MD a Medical Corporation | Past |
Accepting new patients |
Locations
1700 Broadway
#500
Oakland, CA 94612
Phone (510) 273-4200
5674 Stoneridge Dr
Ste 205
Pleasanton, CA 94588
Phone (925) 520-0006
5674 Stoneridge Dr
Ste 207
Pleasanton, CA 94588
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | G83052 | CA | Yes |
Addresses
Primary practice location
225 Academy Ave
Sanger, CA 93657-2128
Mailing address
4174 Levelside Ave
Lakewood, CA 90712-4031
Phone (562) 234-4750
Other practice location 1
506 N Kaweah Ave
Exeter, CA 93221-1271
Phone (559) 594-4969
Other practice location 2
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 233-0425 ext. 130
Other practice location 3
711 N Court St
Visalia, CA 93291-3638
Phone (559) 627-1490
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G83052 | Medicaid | CA | |
| 00G830520 | Medicaid | CA |
Other providers in Sanger, CA
- Juan Carlos Gutierrez
- Kristin Alexandra Guyett
- Malei Guzman
- H S Mann DDS Inc
- Bernadette Hapsari
- Ashley Marie Hazelton
- Heaven Sent Medical Service Inc
- Gene W Heinrichs
- Tom Her
- Jessica E Heredia
All providers in Sanger, CA · Child & Adolescent Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.