Provider Demographics
NPI:1770928061
Name:BEEGEN, TRACY ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:ANN
Last Name:BEEGEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:ANN
Other - Last Name:STRINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 WRIGHT AVE
Mailing Address - Street 2:BLDG 680
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786
Mailing Address - Country:US
Mailing Address - Phone:808-656-1632
Mailing Address - Fax:
Practice Address - Street 1:1200 WRIGHT AVE
Practice Address - Street 2:BLDG 680
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-656-1632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA60814219103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty