Jason, Tracy M
Jason, Tracy M is an individual health care provider with primary practice located at 191 West Burton Mesa Blvd Ste C, Lompoc CA 93436-1400. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jason, Tracy M can be contacted via phone (805) 733-4542.Contact Information
Primary practice address
191 West Burton Mesa Blvd Ste C
Lompoc CA 93436-1400
Phone: (805) 733-4542
Fax: (805) 733-4392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SP14405 | California |
Profile Details
| NPI number | 1104018167 |
|---|---|
| LBN Legal business name | Jason, Tracy M |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2007 |
| Last updated | Aug 14th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104018167 | NPPES |
| California | MEDICAID | GSP000390 |
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