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TRACY WUTZKE PSY.D NPI 1750827499


NPI Information

NPI: 1750827499
Provider Name: TRACY WUTZKE, PSY.D

Other Name: WUTZKE, TRACY

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA
ZIP 92126
Phone: (858) 413-7557
Get Directions

TRACY WUTZKE, PSY.D is a clinical psychologist in San Diego, CA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. TRACY WUTZKE, PSY.D NPI is 1750827499. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Wutzke, Tracy.

The provider's business location address is:

9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA
ZIP 92126-515
Phone: (858) 413-7557
Fax: (858) 217-5285

The provider's authorized official is Tracy Wutzke .
The authorized official title is Clinical Psychologist and has the following contact phone number (858) 413-7557.

The enumeration date for this NPI number is 1/18/2017 and was last updated on 11/14/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106H00000XMarriage & Family Therapist52458CALIFORNIANo
2103TC0700XPsychologistClinicalPSY17239CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10009236145OTHERCALIFORNIAAETNA
2134599523187OTHERCALIFORNIAHUMANA
3100058167001OTHERCALIFORNIABLUE SHIELD OF CALIFORNIA
4240986OTHERCALIFORNIAMHN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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