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Organization

JOHN TRACY CLINIC

Active
Other names
John Tracy Center
Organization subpart
No

Provider details

NPI number
Authorized official
CATHLEEN MARY MATHES M.S.ED, LSLS (PRESIDENT & CEO)
(213) 748-5481
Entity
Organization

Contact information

Practice address
2160 W. ADAMS BLVD, LOS ANGELES, CA 90018-2039
(213) 748-5481
(213) 749-1651
Mailing address
2160 W. ADAMS BLVD, LOS ANGELES, CA 90018-2039
(213) 748-5481
(213) 749-1651

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
235Z00000X
Speech-Language Pathologist
252Y00000X
Early Intervention Provider Agency
191801651
CA

Other

Enumeration date
01/13/2011
Last updated
09/25/2019
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