Individual provider Active NPI

Tracey Lynn Chester, M.S., M.A.

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1740549658
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
93387 Issued in CA
Practice address
4492 Vereda Mar de Ponderosa
San Diego, CA 92130-2667
Phone
(858) 531-3795
NPI assigned
May 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 93387 CA Primary

Addresses

Primary practice location

4492 Vereda Mar de Ponderosa
San Diego, CA 92130-2667

Mailing address

4492 Vereda Mar de Ponderosa
San Diego, CA 92130-2667
Phone (858) 531-3795

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001290 CA Practitioner - Marriage and Family Therapist 9739597923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TLC Family Therapy CorpGroup PAC ID 6305254590, 4 clinicians

Practice addresses (Care Compare)

3455 Ingraham St
San Diego, CA 92109-6713
Phone (442) 777-2040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Family Therapy Corp Marriage & Family Therapist CurrentSince May 4, 2020 Accepting new patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince May 1, 2025 Accepting new patients

Locations

3455 Ingraham St
San Diego, CA 92109
Phone (442) 777-2040

5965 Village Way
Ste 112
San Diego, CA 92130

5405 Morehouse Dr
Ste 120
San Diego, CA 92121
Phone (713) 826-1350

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

Organizations & group practices 2

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1740549658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4492 VEREDA MAR DE PONDEROSA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302667",
            "telephone_number": "858-531-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4492 VEREDA MAR DE PONDEROSA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302667",
            "telephone_number": "858-531-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESTER",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "credential": "M.S., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.