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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 last year

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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