Tracy Johnson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A177199 Issued in CA

Practice address

10330 Pioneer Blvd Ste 215
Santa Fe Springs, CA 90670-8277

Phone

(562) 402-0677

Fax

(323) 544-0967

NPI assigned

Apr 13, 2020

Last updated

Sep 17, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Los Angeles County Department of Mental Health

  dba American Indian Counseling Ctr FSP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Fe Springs, CA
  • NPI 1407089733
  NPD (past)
• Los Angeles County Department of Mental Health

  dba American Indian Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Fe Springs, CA
  • NPI 1679501837
  NPD (past)

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1972122646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 PIONEER BLVD STE 215",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906708277",
            "telephone_number": "562-402-0677",
            "fax_number": "323-544-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 PIONEER BLVD STE 215",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906708277",
            "telephone_number": "562-402-0677",
            "fax_number": "323-544-0967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3115 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-600-2382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TRACY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PTL3958",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A177199",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A177199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Petraglia M.D., Inc
• Alexandria Suzanne Johnson
• Keith Johnson
• Marcellina Johnson, PMHNP-BC
• Sonja Johnson
• Tara Lynn Jojola
• Slettie Morenta Jones, LCSW
• Stephanie Jeannine Jones, LCSW
• Tristan H Jones Sr., LVN
• Asha T Jordan

• Psychiatry Physician in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.