Tracey Lynn Bledsoe, DPT

Individual provider Active NPI Physical Therapist · American Canyon, CA

NPI 1043672058 · NPPES record last updated Feb 11, 2022

Key facts

NPI
1043672058
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
42837 (CA)
Practice address
262 Sheffield Way
American Canyon, CA 94503-1357
Phone
(707) 567-1302
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 42837 CA Yes

Addresses

Primary practice location

262 Sheffield Way
American Canyon, CA 94503-1357

Mailing address

262 Sheffield Way
American Canyon, CA 94503-1357
Phone (707) 567-1302

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Other providers in American Canyon, CA

All providers in American Canyon, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.