Provider Demographics
NPI:1417098583
Name:FOSTER, TRICIA (MSW, LISAC, RN)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MSW, LISAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 N GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-3805
Mailing Address - Country:US
Mailing Address - Phone:520-610-0010
Mailing Address - Fax:
Practice Address - Street 1:75 N GARDEN AVE
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-3805
Practice Address - Country:US
Practice Address - Phone:520-610-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11515101YA0400X
AZ249278163W00000X
CA95352829163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)