Tracy Le Henry, MSN, FNP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95007673 Issued in CA

Practice address

17075 Devonshire St Ste 204
Northridge, CA 91325-5408

Phone

(818) 368-8929

NPI assigned

Nov 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fawzy Basta M D a Professional CorporationGroup PAC ID 4880639814, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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.

• Fawzy Basta M D a Professional Corporation

  • Psychiatry Physician
  • Northridge, CA
  • NPI 1508932500
  Medicare reassignment Care Compare group NPD
• Mindfull Balance Advanced Nursing

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, CA
  • NPI 1326835265

  Family

  Medicare reassignment NPD Authorized official
• Mission City Community Network, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hollywood, CA
  • NPI 1710102009
  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Primary Care Clinic/Center
  • Monrovia, CA
  • NPI 1063795250
  NPD
• Mission City Community Network, Inc.

  • Community Health Clinic/Center
  • North Hills, CA
  • NPI 1710370747
  NPD

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1295249225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HOUSEMAN ST",
            "city": "LA CANADA FLINTRIDGE",
            "state": "CA",
            "postal_code": "910112638",
            "telephone_number": "310-902-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "818-368-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "TRACY",
        "middle_name": "LE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "65007673",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95007673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi L Chan DDS Inc
• Jeremy Scott Helmers, LVN
• Rushdi Yousef Helo, DC
• Susan Joy Henderson, D.C.
• Michal Abellon Hendry, FNP
• Arriane Henryhand, MMT
• Michael S Hepfer, MD
• Hera Hospice, Inc.
• Shea Herald
• Heritage Provider Network, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Northridge, CA
• Providers in Northridge, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.