Provider Demographics
NPI:1134477995
Name:HESSE, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:HESSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LEE
Other - Last Name:DROPPING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1436 2ND ST # 117
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2824
Mailing Address - Country:US
Mailing Address - Phone:707-312-0606
Mailing Address - Fax:
Practice Address - Street 1:1436 2ND ST # 117
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2824
Practice Address - Country:US
Practice Address - Phone:707-312-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF777714106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program