Individual
MRS. TRACEY WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
614 W MANCHESTER BLVD STE 202, INGLEWOOD, CA 90301-1685
(323) 363-2069
Mailing address
PO BOX 882588, LOS ANGELES, CA 90009-3626
(323) 363-2069
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
03/02/2026
Last updated
03/06/2026
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