Tracy Small III, AMFT APCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

12625 Hesperia Rd
Victorville, CA 92395-7720

Phone

(760) 995-8385

NPI assigned

Jul 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Nationwide Medical Group, Inc

  • Community Health Clinic/Center
  • Stockton, CA
  • NPI 1548317951
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1730564717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127 MALL BLVD STE A115",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923927665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957720",
            "telephone_number": "760-995-8385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 E Foothill Blvd",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923765230",
            "country_code": "US",
            "telephone_number": "909-421-4660 x19347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 N Hollywood Way Ste 102",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915055031",
            "country_code": "US",
            "telephone_number": "866-727-8274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11776 Mariposa Rd",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451622",
            "country_code": "US",
            "telephone_number": "760-956-2462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "TRACY",
        "name_suffix": "III",
        "credential": "AMFT APCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Six Degrees, Inc. (Prescription Shoppe)
• Daniel Sixtos
• Rickey Skare
• Warren Sloan, FNP
• Christine Sloat, NURSE PRACTITIONER
• Loyia Smiley
• Jamie Tyushi Smith-Baber, REGISTERED NURSE
• Ashley Smith
• Benjamin Andrew Smith, BCBA
• Charles Stuart Smith, RADT R1543910124

• Marriage & Family Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.