Individual provider Active NPI

Tracy M White, MA

  • Speech-Language Pathologist
  • Paso Robles, CA
National Provider Identifier
1104018167
Registry record updated Jun 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP14405 Issued in CA
Practice address
7419 Shale Rock Rd
Paso Robles, CA 93446-9378
Phone
(805) 610-5561
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP14405 CA Primary

Addresses

Primary practice location

7419 Shale Rock Rd
Paso Robles, CA 93446-9378

Mailing address

PO Box 2466
Paso Robles, CA 93447-2466
Phone (805) 610-5561

Other identifiers 1

IdentifierTypeStateIssuer
GSP000390MedicaidCA

Other names 1

  • Tracy M Jason Former name

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP14405CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750550400000",
    "number": "1104018167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2466",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934472466",
            "telephone_number": "805-610-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7419 SHALE ROCK RD",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934469378",
            "telephone_number": "805-610-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TRACY",
        "middle_name": "M",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP14405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSP000390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "JASON",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.