Tracy Marie Vega, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

92354 Issued in CA

Practice address

3230 Kerner Blvd
San Rafael, CA 94901-4840

Phone

(415) 473-2611

Fax

(415) 473-3080

NPI assigned

Mar 12, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1508325234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-2611",
            "fax_number": "415-473-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-2611",
            "fax_number": "415-473-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW76850",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "92354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvega@marincounty.org",
            "affiliation": "N",
            "address_1": "3230 Kerner Blvd",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949014840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvega@marincounty.org",
            "affiliation": "N",
            "address_1": "3230 Kerner Blvd",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949014840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jainy Vathikulam, DO
• Marsha Vaughn, LCSW
• Dallas Marie Vazquez
• Harish Veerapalli
• Maria G. Vega
• Natrada Vejjadham
• Vasundhara-Devi Vemula, M.D.
• Jennifer D Venezia
• Jaimalynne Ventura
• Cynthia Lynn Vergara, M.S., MFT

• Clinical Social Worker in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.