Kennedy, Tracy

Kennedy, Tracy is an individual health care provider with primary practice located at 716 Ocean St , Santa Cruz CA 95060-4032. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kennedy, Tracy can be contacted via phone (831) 465-4907.

Contact Information

Primary practice address
716 Ocean St Santa Cruz CA 95060-4032
Phone: (831) 465-4907
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ASW105315 California

Profile Details

NPI number 1790217073
LBN Legal business name Kennedy, Tracy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2017
Last updated Sep 10th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790217073 NPPES
California Other ASW105315 BOARD OF BEHAVIORAL SCIENCES

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