TRACEY LEE PIMENTEL MA LAADC NPI 1518479633

NPI Information

NPI: 1518479633
Provider Name: TRACEY LEE PIMENTEL, MA, LAADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
2550 W CLINTON AVE
FRESNO, CA
ZIP 93705
Phone: (559) 264-7521
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Tracey Lee Pimentel, MA, LAADC is an addiction (substance use disorder) counselor in Fresno, CA. Tracey Lee Pimentel, MA, LAADC NPI is 1518479633. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2550 W CLINTON AVE
FRESNO, CA
ZIP 93705-206
Phone: (559) 264-7521

The enumeration date for this NPI number is 10/30/2017 and was last updated on 11/14/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LR10081221	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LR10081221	OTHER	CALIFORNIA	CCAPP

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

NPI Synchronization or Removal

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