Tracy Adell Neal-Walden, PH.D.

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

35-580 Issued in MS

Practice address

30 Nightingale Rd
Mdos/CC
Edwards, CA 93524-0001

Phone

(661) 277-2183

NPI assigned

May 23, 2007

Last updated

Feb 16, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1962612762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 LUPINE CIR",
            "city": "EDWARDS",
            "state": "CA",
            "postal_code": "935232416",
            "telephone_number": "210-324-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NIGHTINGALE RD",
            "address_2": "MDOS/CC",
            "city": "EDWARDS",
            "state": "CA",
            "postal_code": "935240001",
            "telephone_number": "661-277-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL-WALDEN",
        "first_name": "TRACY",
        "middle_name": "ADELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MS",
            "license": "35-580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pang Ko, D.M.D.
• Phillip Lopiccolo, D.D.S.
• Franklin Miranda, IDMT
• Cheyenne E Monroe-Backus, LCSW
• David George Morrison Jr., PA-C
• Rebecca Michelle Orr, PHARMD
• Austin Puente, IDMT
• Carolina Ramirez, M.S., CCC-SLP
• Harry Mark Richter, DDS MAGD
• Tamara Hopper Shoulders, PT

• Health Psychologist in Edwards, CA
• Providers in Edwards, CA by specialty
• Health Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.