Provider Demographics
NPI:1124225941
Name:DAND, TRACY (MFT)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:
Last Name:DAND
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E HUNTINGTON DR
Mailing Address - Street 2:SUITE 333
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-6203
Mailing Address - Country:US
Mailing Address - Phone:626-432-4099
Mailing Address - Fax:
Practice Address - Street 1:444 E HUNTINGTON DR
Practice Address - Street 2:SUITE 333
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-6203
Practice Address - Country:US
Practice Address - Phone:626-432-4099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28985106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist