Provider Demographics
NPI:1942428909
Name:SCHWEIZER, TRACEY ALAN (LMFT)
Entity type:Individual
Prefix:MR
First Name:TRACEY
Middle Name:ALAN
Last Name:SCHWEIZER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:T.
Other - Middle Name:ALAN
Other - Last Name:SCHWEIZER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:20216 ROSCOE BLVD UNIT 6
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-1686
Mailing Address - Country:US
Mailing Address - Phone:818-359-2895
Mailing Address - Fax:
Practice Address - Street 1:210 SOUTH DELACEY AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2074
Practice Address - Country:US
Practice Address - Phone:626-395-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45336106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB07035OtherLA DMH PROVIDER
CA00007473Medicaid