Tracy Phelps

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

1550 Iron Point Rd
Folsom, CA 95630-7802

Phone

(301) 363-0019

NPI assigned

Feb 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1982297644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 IRON POINT RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956307802",
            "telephone_number": "301-363-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 IRON POINT RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956307802",
            "telephone_number": "301-363-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13137727",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanh Thi Pham, D.D.S.
• Tiffany H Phan, OD, FAAO
• Alicia Cherie Pharis
• Aida S. Phelan, M.D.
• Timothy Edwin Phelan, M.D.
• Julie Ann Huat Phenco, M.D.
• Nayah Phetdara
• Philip J Orisek, M.D. Inc.
• Corrie Deann Phipps, SLPA
• Darcy Pierce

• Clinical Neuropsychologist in Folsom, CA
• Providers in Folsom, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; 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.