Tracey Black, is a
Community Health Worker based in Stockton, California. Tracey Black is licensed to practice in * (Not Available) (license number ) and her current practice location is
1212 N California St, Stockton, California. She can be reached at her office (for appointments etc.) via phone at
(209) 468-8842.
NPI number for Tracey Black is 1740893155 and her current mailing address is 538 N Lincoln Ave, Manteca, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1740893155.
Healthcare Provider's Profile
| Full Name | Tracey Black |
|---|
| Gender | Female |
|---|
| Speciality | Community Health Worker |
|---|
| Location | 1212 N California St, Stockton, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1740893155
- Provider Enumeration Date: 08/25/2020
- Last Update Date: 03/26/2025
Medical Identifiers
Medical identifiers for Tracey Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740893155 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (California) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C041740417 (California) | Secondary |
| 373H00000X | Day Training/habilitation Specialist | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tracey Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tracey Black,
538 N Lincoln Ave,
Manteca, CA 95336-3940
Ph: (209) 679-7309 | Tracey Black,
1212 N California St,
Stockton, CA 95202-1552
Ph: (209) 468-8842 |
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