Individual provider Active NPI

Tracey Preston, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Murrieta, CA
National Provider Identifier
1508748575
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95034552 Issued in CA
Practice address
41604 Evening Shade PL
Murrieta, CA 92562-9542
Phone
(951) 440-3350
NPI assigned
Jul 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95034552 CA Primary

Addresses

Primary practice location

41604 Evening Shade PL
Murrieta, CA 92562-9542

Mailing address

41604 Evening Shade PL
Murrieta, CA 92562-9542
Phone (951) 440-3350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305001422 CA Practitioner - Psychiatry 3274015532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dazzle Health P CGroup PAC ID 4082146634, 26 clinicians

Practice addresses (Care Compare)

18650 Macarthur Blvd
Irvine, CA 92612-1244
Phone (412) 996-9012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95025888CAMDCritical Care Medicine Nurse Practitioner
NP95034552CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dazzle Health P C CurrentSince Jan 15, 2026 Accepting new patients

Locations

18650 MacArthur Blvd
Irvine, CA 92612
Phone (412) 996-9012

18650 MacArthur Blvd
Ste 450
Irvine, CA 92612
Phone (949) 570-7750

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1508748575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41604 EVENING SHADE PL",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629542",
            "telephone_number": "951-440-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41604 EVENING SHADE PL",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629542",
            "telephone_number": "951-440-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "TRACEY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95034552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.