Tracie Maria Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95028805 Issued in CA

Practice address

1040 Davis St Ste 202
San Leandro, CA 94577-1519

Phone

(510) 777-1000

NPI assigned

Jul 26, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Osita Health Clinic

  • Clinic/Center
  • Oakland, CA
  • NPI 1649743345
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1063240356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 DAVIS ST STE 202",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945771519",
            "telephone_number": "510-777-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 DAVIS ST STE 202",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945771519",
            "telephone_number": "510-777-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRACIE",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "702324",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Smith, PSYD
• Paul Smith
• Sarah Margaret Smith, LCSW
• Shannon S Smith
• Susan Smith
• Danielle Smits
• Katherine M Smolley, CNM
• Herbert Dominique Smyer II
• Tyrone Emanuel Snipes, D.O.
• Irene Dawes Snyder

• Family Nurse Practitioner in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.