Provider Demographics
NPI:1417087628
Name:BEGG, TRACY ANN (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:ANN
Last Name:BEGG
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5493 ADOBE FALLS RD
Mailing Address - Street 2:APT. #16
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-4494
Mailing Address - Country:US
Mailing Address - Phone:619-265-5268
Mailing Address - Fax:
Practice Address - Street 1:3075 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2773
Practice Address - Country:US
Practice Address - Phone:858-939-5043
Practice Address - Fax:858-939-5044
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA878376133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered