Traci Leanne Pavlas, CRC, NPN

Primary specialty

CounselorTaxonomy code 101Y00000X

License

148809 Issued in CA

Practice address

1402 Pennsylvania Ave Apt 12
San Diego, CA 92103-4561

Phone

(619) 988-1218

NPI assigned

Oct 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1215709332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 PENNSYLVANIA AVE APT 12",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034561",
            "telephone_number": "619-988-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 PENNSYLVANIA AVE APT 12",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034561",
            "telephone_number": "619-988-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLAS",
        "first_name": "TRACI",
        "middle_name": "LEANNE",
        "credential": "CRC, NPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "148809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Pavia
• Austin Pavin
• Anthony Pavlacka, BCBA
• Amanda Marie Pavlak
• Tobi Alexandra Pavlas, ASW
• Amy Kristin Pavlik, RD
• Desiree M Pavlik
• Katherine Rose Pavlik, CMT
• Andrew Joseph Pavlov, PT, DPT, CSCS
• Wendy D Pavlovich, MD

• Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.