Tracy Lynn Carlis, PHD

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

PSY16888 Issued in CA

Practice address

5000 Hayvenhurst Ave
Encino, CA 91436-1115

Phone

(818) 713-0508

Fax

(818) 703-8050

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730225640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HAYVENHURST AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361115",
            "telephone_number": "818-713-0508",
            "fax_number": "818-703-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HAYVENHURST AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361115",
            "telephone_number": "818-713-0508",
            "fax_number": "818-703-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLIS",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "CA",
            "license": "PSY16888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caring Joy Home Care
• Caring Joy Providers
• Carl I Blau M D Inc
• Kirstin F Carl, L.M.F.T.
• Maury Theodore Carlin I, PH.D.
• Elliot Ryan Carlisle, M.D.
• Eric S Carlisle, MD
• Evangeline Carlos, PHARMD
• Evelyn G Carlos, DMD
• Carol a. Polevoi, LMFT/Wellness Coach, Apc

• Ph.D. Medical Genetics in Encino, CA
• Providers in Encino, CA by specialty
• Ph.D. Medical Genetics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.