Tracy Dreas-Penrod, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13225 Issued in CA

Practice address

1809 National Ave
San Diego, CA 92113-2113

Phone

(619) 515-2300

NPI assigned

Feb 19, 2007

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)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467596791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132113",
            "telephone_number": "619-515-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 Gateway Center Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024541",
            "country_code": "US",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DREAS-PENROD",
        "first_name": "TRACY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "13225",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Christopher Draws, DDS
• Aj Young Draz, ASW
• Dream Sleep & Wellness Solutions
• Dream Wellness PB
• Dreamscape Ketamine and IV Therapy Lounge
• Aleksandra Chatren Drecun, PSY.D.
• Sharon Marie Dreeben, M.D.
• Heidemarie Dreger, CRNA
• Brian Dreher, DO
• Margaret A. Drehobl, M.D.

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.