Individual provider Active NPI

Tracey Catherine Scalise, LVN

  • Licensed Vocational Nurse
  • Berkeley, CA
National Provider Identifier
1770077935
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
230394 Issued in CA
Practice address
2323 Hearst Ave
Berkeley, CA 94709-1319
Phone
(866) 772-8075
NPI assigned
Jun 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 230394 CA Primary

Addresses

Primary practice location

2323 Hearst Ave
Berkeley, CA 94709-1319

Mailing address

4633 La Vista Dr
Oakley, CA 94561-4141
Phone (925) 768-5937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
230394CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1770077935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 LA VISTA DR",
            "city": "OAKLEY",
            "state": "CA",
            "postal_code": "945614141",
            "telephone_number": "925-768-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 HEARST AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091319",
            "telephone_number": "866-772-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALISE",
        "first_name": "TRACEY",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "230394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.