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Tracie Jackson
NPI 1275181414 · on the registry since 2019
Practice
- Address
- 1274 Center Court Dr Ste 211
Covina, CA 91724 - Phone
- (909) 231-5639
- Organisation at this address
- Howard J. Chudler & Associates, Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 1,864
Additional practice sites
- 3620 N Rancho Dr Ste 117, Las Vegas, NV
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 372600000X
3747A0650X
372500000X
3747P1801X
376J00000X - Licence states on file
- NV, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-04-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California