Active NPI
Tracy Ann Holcomb Brackin, MFT
- Marriage & Family Therapist
- Woodland Hills, CA
National Provider Identifier
1962534594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 62576
- Practice address
- 4900 Serrania Ave
Woodland Hills, CA 91364-3301 - Phone
- (818) 657-3143
- Fax
- (818) 347-0184
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 62576 | CA | Primary |
Addresses
Primary practice location
4900 Serrania Ave
Woodland Hills, CA 91364-3301
Mailing address
9217 Sophia Ave
North Hills, CA 91343-3811
Phone (818) 891-4361
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 |
|---|---|---|---|
| 62576 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1962534594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9217 SOPHIA AVE",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913433811",
"telephone_number": "818-891-4361",
"fax_number": "818-347-0184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 SERRANIA AVE",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913643301",
"telephone_number": "818-657-3143",
"fax_number": "818-347-0184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLCOMB BRACKIN",
"first_name": "TRACY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "62576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.