Provider Demographics
NPI:1588160840
Name:PAPAGIANNIS, TRACY
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:PAPAGIANNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BIRTY CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-1702
Mailing Address - Country:US
Mailing Address - Phone:916-502-1727
Mailing Address - Fax:
Practice Address - Street 1:12 BIRTY CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-1702
Practice Address - Country:US
Practice Address - Phone:916-502-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health