Provider Demographics
NPI:1225112501
Name:WOO, TRACY LEE (MFT)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LEE
Last Name:WOO
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 1:5784 LOLET WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2405
Mailing Address - Country:US
Mailing Address - Phone:916-607-6557
Mailing Address - Fax:
Practice Address - Street 1:9837 FOLSOM BLVD
Practice Address - Street 2:STE F
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-856-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49034106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist