Jackson, Tracie Latrice
Jackson, Tracie Latrice is an individual health care provider with primary practice located at 1274 Center Court Dr Ste 211 , Covina CA 91724-3668. She recently has 6 registered licenses in different health care specialties including Nursing Service Related Providers / Adult Companion, Nursing Service Related Providers / Attendant Care Provider, Nursing Service Related Providers / Chore Provider, Nursing Service Related Providers / Personal Care Attendant, Nursing Service Related Providers / Homemaker, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Jackson, Tracie Latrice can be contacted via phone (909) 231-5639.Contact Information
Primary practice address
1274 Center Court Dr Ste 211
Covina CA 91724-3668
Phone: (909) 231-5639
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Related Providers / Adult Companion | 372600000X | Nevada | |
Nursing Service Related Providers / Attendant Care Provider | 3747A0650X | Nevada | |
Nursing Service Related Providers / Chore Provider | 372500000X | Nevada | |
Nursing Service Related Providers / Personal Care Attendant | 3747P1801X | Nevada | |
Nursing Service Related Providers / Homemaker | 376J00000X | Nevada | |
Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | California |
Profile Details
NPI number | 1275181414 |
---|---|
LBN Legal business name | Jackson, Tracie Latrice |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 30th, 2019 |
Last updated | Apr 3rd, 2024 - about 7 months 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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