Trecia Jean Hall, CNA

Key facts

NPI

1104635473

Entity type

Individual (NPI type 1)

Primary specialty

Adult Development & Aging Psychologist 103TA0700X

Practice address

5400 Coraci Blvd Apt 7202
Port Orange, FL 32128-7581

Phone

(352) 718-4888

NPI assigned

Jan 2, 2025

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)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 2, 2025.

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1104635473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 CORACI BLVD APT 7202",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287581",
            "telephone_number": "352-718-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 CORACI BLVD APT 7202",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287581",
            "telephone_number": "352-718-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "TRECIA",
        "middle_name": "JEAN",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

• Halifax Healthcare Systems Inc
• Halifax Hospice Inc
• Halifax Pathology Associates PA
• Halifax Pathology Associates PA
• Nora Hall, BA
• Megan Haller
• Rachael A Hammel, NP
• Rebecca Leigh Hammond
• Kacee Hampshire
• Casey Hampton

All providers in Port Orange, FL · Adult Development & Aging Psychologist in Florida