Tracy Lynn Gereau, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF38751 Issued in CA

Practice address

120 W Hawthorne St
Fallbrook, CA 92028-2053

Phone

(760) 731-3235

Fax

(760) 731-4950

NPI assigned

Mar 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366574980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3762 VIA DEL RANCHO",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920567208",
            "telephone_number": "760-450-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W HAWTHORNE ST",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920282053",
            "telephone_number": "760-731-3235",
            "fax_number": "760-731-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEREAU",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF38751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL STAFF NUMBER",
            "identifier": "6770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.