Active NPI
Amanda D Tracy, ND
- Naturopath
- Fairfield, CA
National Provider Identifier
1871675157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- ND1178
- Practice address
- 118 Cherry Valley CT
Fairfield, CA 94534-7514 - Phone
- (707) 759-5029
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 0990000188 | VT | |
| Naturopath | 175F00000X | ND1178 | CA | Primary |
Addresses
Primary practice location
118 Cherry Valley CT
Fairfield, CA 94534-7514
Mailing address
2401-A Waterman Blvd
Ste 4 #296
Fairfield, CA 94534-1800
Phone (781) 726-2878
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
| License | State | Type | Specialty |
|---|---|---|---|
| ND1178 | CA | MD | Naturopath |
| 0990000188 | VT | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1871675157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401-A WATERMAN BLVD",
"address_2": "STE 4 #296",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945341800",
"telephone_number": "781-726-2878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 CHERRY VALLEY CT",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945347514",
"telephone_number": "707-759-5029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "AMANDA",
"middle_name": "D",
"credential": "ND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2022-11-07",
"certification_date": "2022-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "VT",
"license": "0990000188",
"primary": false
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "CA",
"license": "ND1178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.