Individual provider Active NPI

Tracey Trahan, RN

  • Psychiatric/Mental Health Registered Nurse
  • Lafayette, LA
National Provider Identifier
1073044632
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
95136630 Issued in CA
Practice address
106 Heymann Blvd
Lafayette, LA 70503-2322
Phone
(337) 504-4269
NPI assigned
Mar 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN138633 LA
Psychiatric/Mental Health Registered Nurse 163WP0808X 95136630 CA Primary

Addresses

Primary practice location

106 Heymann Blvd
Lafayette, LA 70503-2322

Mailing address

9808 Venice Blvd., Ste. 505
Culver City, CA 90232-6269
Phone (310) 945-3350

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN138633LAMDRegistered Nurse
95136630CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1073044632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD., STE. 505",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326269",
            "telephone_number": "310-945-3350",
            "fax_number": "310-945-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032322",
            "telephone_number": "337-504-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAHAN",
        "first_name": "TRACEY",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN138633",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95136630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.