Traci Jo Watson, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

18 Technology Dr Ste 118
Irvine, CA 92618-2310

Phone

(949) 922-4564

NPI assigned

Mar 3, 2022

Sex

Female

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Jul 16, 2024 through Jul 16, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connect Play Therapy & Family Therapy, Inc.

  dba Connected Life Center

  • Adolescent and Children Mental Health Clinic/Center
  • Irvine, CA
  • NPI 1003563404
  NPD

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1275280885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TECHNOLOGY DR STE 118",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182310",
            "telephone_number": "949-922-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 TECHNOLOGY DR STE 118",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182310",
            "telephone_number": "949-922-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TRACI",
        "middle_name": "JO",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Ann Watkins, PA-C
• Nicole Watkins
• Katey Watry
• Karen J Watson
• Kenneth Michael Watson
• Michele Watters
• Wave Imaging, LLC (MemorialCare Imaging Center-Irvine)
• Brittney Way
• Katusha Way
• Waymakers

• Mental Health Counselor in Irvine, CA
• Providers in Irvine, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.