Provider Information for 1972749323
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TRACI WITT LMFT
Sex: Female
NPI: 1972749323
Last Updated: 2023-07-03
Certification Date: 2023-07-03
Certification Date: 2023-07-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1972749323 | ||||||||||||
| Enumeration Date | 2009-01-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3050 UNION ST ROCKLIN, CA 95677-1837 United States Phone: 530-368-4199 | Fax: | ||||||||||||
| Primary Practice Address | 3050 UNION ST ROCKLIN, CA 95677-1837 United States Phone: 530-368-4199 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 8421 AUBURN BLVD STE 110 | ||||||||||||
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