Individual
TRACEY ANN KNICKERBOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
650 HOWE AVE, SACRAMENTO, CA 95825-4731
(916) 533-6067
Mailing address
650 HOWE AVE, SACRAMENTO, CA 95825-4731
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
01/21/2026
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