Organization Active NPI

Tracey Walters LLC

  • Community/Behavioral Health Agency
  • Inglewood, CA
National Provider Identifier
1063397149
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TRACEY WALTERS LLC
Practice address
614 W Manchester Blvd # 201-202
Inglewood, CA 90301-1656
Phone
(323) 363-2069
NPI assigned
Aug 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Authorized official

Name
Ms. Tracey WaltersNPI 1831044387
Title
Peer Support Specialist
Phone
(323) 363-2069

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

614 W Manchester Blvd # 201-202
Inglewood, CA 90301-1656

Mailing address

PO Box 882588
Los Angeles, CA 90009-3626
Phone (323) 363-2069

Other names 1

  • Peer Support Specialist Doing business as

National Provider Directory

National Provider Directory

Locations

614 W Manchester Blvd
#201202
Inglewood, CA 90301
Phone (323) 363-2069

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1063397149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882588",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900093626",
            "telephone_number": "323-363-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 W MANCHESTER BLVD # 201-202",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011656",
            "telephone_number": "323-363-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACEY WALTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PEER SUPPORT SPECIALIST",
        "authorized_official_telephone_number": "323-363-2069",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peer Support Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.