Active NPI
Tracy M Gillette, PH.D.
- Clinical Psychologist
- Santa Barbara, CA
National Provider Identifier
1437487824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 30853
- Practice address
- 1010 Garden St
Santa Barbara, CA 93101-1417 - Phone
- (612) 242-5830
- NPI assigned
- Nov 24, 2009
- 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 Psychologist | 103TC0700X | 30853 | CA | Primary |
Addresses
Primary practice location
1010 Garden St
Santa Barbara, CA 93101-1417
Mailing address
3644 San Gabriel LN
Santa Barbara, CA 93105-3215
Phone (612) 242-5830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 29, 2024 through Nov 29, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30853 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1437487824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3644 SAN GABRIEL LN",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931053215",
"telephone_number": "612-242-5830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 GARDEN ST",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931011417",
"telephone_number": "612-242-5830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLETTE",
"first_name": "TRACY",
"middle_name": "M",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-24",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "30853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.