Individual
TRACY I GASTELUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 526-4500
Mailing address
1001 N CENTRAL AVE, MODESTO, CA 95351-4804
(209) 606-7800
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95033701
CA
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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