Active NPI
Tracie Jean Estes, LCSW
- Clinical Social Worker
- Redondo Beach, CA
National Provider Identifier
1306020748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS17758
- Practice address
- 407 Avenue G Apt 4
Redondo Beach, CA 90277-5919 - Phone
- (310) 316-4584
- NPI assigned
- Dec 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS17758 | CA | Primary |
Addresses
Primary practice location
407 Avenue G Apt 4
Redondo Beach, CA 90277-5919
Mailing address
407 Avenue G Apt 4
Redondo Beach, CA 90277-5919
Phone (310) 316-4584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS17758 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1306020748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 AVENUE G APT 4",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902775919",
"telephone_number": "310-316-4584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 AVENUE G APT 4",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902775919",
"telephone_number": "310-316-4584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTES",
"first_name": "TRACIE",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-20",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS17758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.