Provider Demographics
NPI:1346964889
Name:TRACY LEFFLER LMFT
Entity Type:Organization
Organization Name:TRACY LEFFLER LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-430-4495
Mailing Address - Street 1:301 MOTT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3732
Mailing Address - Country:US
Mailing Address - Phone:559-430-4495
Mailing Address - Fax:
Practice Address - Street 1:7571 N REMINGTON AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5799
Practice Address - Country:US
Practice Address - Phone:559-430-4495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty