Individual provider Active NPI

Tracy Lynn Preece, PH.D.

  • Clinical Psychologist
  • Carlsbad, CA
National Provider Identifier
1104861202
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16177 Issued in CA
Practice address
2725 Jefferson St Ste 10
Carlsbad, CA 92008-1708
Phone
(760) 213-7204
Fax
(760) 434-9778
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16177 CA Primary

Addresses

Primary practice location

2725 Jefferson St Ste 10
Carlsbad, CA 92008-1708

Mailing address

2725 Jefferson St Ste 10
Carlsbad, CA 92008-1708
Phone (760) 213-7204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080424000673 CA Practitioner - Clinical Psychologist 5597843938 Practice locations: Carlsbad, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3150 El Camino Real
Suite C
Carlsbad, CA 92008-2110
Phone (760) 213-7204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16177CAMDClinical Psychologist
16177CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1104861202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 JEFFERSON ST STE 10",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081708",
            "telephone_number": "760-213-7204",
            "fax_number": "760-434-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 JEFFERSON ST STE 10",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081708",
            "telephone_number": "760-213-7204",
            "fax_number": "760-434-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREECE",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.