Provider Demographics
NPI:1255580544
Name:FLOWERS-NED, TRACI (IMF)
Entity type:Individual
Prefix:MS
First Name:TRACI
Middle Name:
Last Name:FLOWERS-NED
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 12TH ST STE 200
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1297
Mailing Address - Country:US
Mailing Address - Phone:415-321-3152
Mailing Address - Fax:415-554-1914
Practice Address - Street 1:68 12TH ST STE 200
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1297
Practice Address - Country:US
Practice Address - Phone:415-321-3152
Practice Address - Fax:415-554-1914
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA66676106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor