Active NPI
Tracye Elizabeth Davis, S2N6Z3L5
- Behavior Technician
- Fremont, CA
National Provider Identifier
1386487569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- S2N6Z3L5
- Practice address
- 41299 Paseo Padre Pkwy Apt 1
Fremont, CA 94539-4569 - Phone
- (510) 493-1207
- NPI assigned
- Jun 17, 2024
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | S2N6Z3L5 | CA | Primary |
Addresses
Primary practice location
41299 Paseo Padre Pkwy Apt 1
Fremont, CA 94539-4569
Mailing address
41299 Paseo Padre Pkwy Apt 1
Fremont, CA 94539-4569
Phone (510) 493-1207
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 |
|---|---|---|---|
| S2N6Z3L5 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1386487569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41299 PASEO PADRE PKWY APT 1",
"city": "FREMONT",
"state": "CA",
"postal_code": "945394569",
"telephone_number": "510-493-1207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41299 PASEO PADRE PKWY APT 1",
"city": "FREMONT",
"state": "CA",
"postal_code": "945394569",
"telephone_number": "510-493-1207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TRACYE",
"middle_name": "ELIZABETH",
"credential": "S2N6Z3L5",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "S2N6Z3L5",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.