Provider Demographics
NPI:1417075714
Name:HESS, TRACEY LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:LEE
Last Name:HESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 N PUEBLO AVE
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2234
Mailing Address - Country:US
Mailing Address - Phone:805-689-1796
Mailing Address - Fax:
Practice Address - Street 1:701 E SANTA CLARA ST STE 14C
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-5972
Practice Address - Country:US
Practice Address - Phone:805-689-1796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27154103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical