Traci Brown-Bailey
Individual provider Active NPI Rehabilitation Practitioner · Grand Terrace, CA
NPI 1417714908 · NPPES record last updated May 17, 2026
Key facts
- NPI
- 1417714908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rehabilitation Practitioner 225400000X
- Practice address
- 22365 Barton Rd Ste 302
Grand Terrace, CA 92313-5078 - Phone
- (909) 370-2858
- NPI assigned
- Mar 1, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chastella Inc | Rehabilitation Practitioner | Current |
Accepting new patients |
| Wholeness Empowerment Group Licensed Clinical Social Worker, Inc | Current |
Accepting new patients | |
| Chastella Inc | Rehabilitation Practitioner | Current |
Accepting new patients |
Locations
22365 Barton Rd
Ste 302
Grand Terrace, CA 92313
Phone (909) 370-2858
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Rehabilitation Practitioner | 225400000X | CA | Yes |
Addresses
Primary practice location
22365 Barton Rd Ste 302
Grand Terrace, CA 92313-5078
Mailing address
PO Box 1170
Moreno Valley, CA 92556-1170
Phone (909) 370-2858
Other practice location 1
6767 W Tropicana Ave
Las Vegas, NV 89103-4754
Phone (702) 209-0370
Other providers in Grand Terrace, CA
- Zakari Larbi Bissani
- Kelsy Bonnet
- Breaking Cycles Counseling
- William Martin Breer
- Broadscope LLC
- Latoya Mae Brown
- Jamaal Burrell
- Kaylee Skye Rubio Cajimat
- Donna Cano
- Capacity Physical Therapy & Sports Performance
All providers in Grand Terrace, CA · Rehabilitation Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.