Individual
TRACY DERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCH
Contact information
Practice address
24511 W JAYNE AVE, COALINGA, CA 93210-9503
(559) 935-4301
(559) 935-7118
Mailing address
1600 9TH ST, ROOM 205 MAILSTOP 2-3, SACRAMENTO, CA 95814-6404
(916) 654-2431
(916) 654-3186
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
PSY20534
CA
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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