Tracy Lewellen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

19376 Issued in CA

Practice address

388 Market St
San Francisco, CA 94111-5311

Phone

(415) 799-7117

NPI assigned

Aug 25, 2014

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

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 Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465
  NPD (past)

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356741672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 MARKET ST STE 1010",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115315",
            "telephone_number": "415-799-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 MARKET ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115311",
            "telephone_number": "415-799-7117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1421 Broderick St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941153304",
            "country_code": "US",
            "telephone_number": "415-292-1760 x27",
            "fax_number": "415-292-1636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWELLEN",
        "first_name": "TRACY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "19376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Lewak, M.D.
• Shevaun M Lewallen, NP
• Marie Ann Lewandowski, MD
• Peter Paul Lewandowski, D.C.
• Sean Andrew Lewandowski, ACNP
• Laura Lewin
• Matthew R. Lewin, MD, PHD
• Sara Michelle Epstein Lewin, M.D.
• Thu Anh Lewin, FNP
• Lewis Engel, PHD

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.