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Tracie Latrice Jackson

Behavior Analyst β€’ Covina, CA

Active NPI 1275181414 Individual Practitioner Female Practitioner
Practice location in NPPES

1274 Center Court Dr Ste 211
Covina, CA 917243668

Call 9092315639 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1274 Center Court Dr Ste 211

Covina, CA 917243668

Telephone 9092315639
Organization at the Same NPPES Address or Phone
Howard J. Chudler & Associates, Inc Facility NPI 1497007306

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Las Vegas, NV. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Covina and California

186 active clinicians are listed under Behavior Analyst with a practice address in Covina, CA (20,363 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Covina

0% of these 186 clinicians have the CMS telehealth indicator.

0% of these 186 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-04-03
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Adult Companion

NUCC Taxonomy Code: 372600000X

An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.

Technician - Attendant Care Provider

NUCC Taxonomy Code: 3747A0650X

An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.

Chore Provider

NUCC Taxonomy Code: 372500000X

An individual who provides home maintenance services required to sustain a safe, sanitary living environment for individuals who because of age or disabilities is unable to perform the activities. These services include heavy household chores such as washing floors, windows, and walls; tacking down loose rugs and tiles; and moving heavy items of furniture in order to provide safe access and egress.

Technician - Personal Care Attendant

NUCC Taxonomy Code: 3747P1801X

An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards

Homemaker

NUCC Taxonomy Code: 376J00000X

An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Secondary Practice Locations

3620 N Rancho Dr Ste 117

Las Vegas, NV 891303154

Phone: 7252513737

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Anthony Sanchez , MD

Behavior Technician

NPI 1538795562

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location April 03, 2024

Registered at 1274 CENTER COURT DR STE 211, COVINA, CA 917243668 (Tel: 9092315639)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2024

Adult Companion

βœ…
NPI Profile Active August 30, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 30, 2019

Registered at 3620 N RANCHO DR STE 117, LAS VEGAS, NV 891303154 (Tel: 7252513737)

πŸ“
Business Mailing Address (Initial Record) August 30, 2019

Registered at 3620 N RANCHO DR STE 117, LAS VEGAS, NV 891303154 (Tel: 7252513737)

πŸ‘€
Provider Name / Credentials (Initial Record) August 30, 2019

Recorded as TRACIE JACKSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 30, 2019

Chore Provider

🟒
Initial NPI Registration & Enumeration August 30, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1275181414
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 30, 2019
Last Update: April 03, 2024
Sole Proprietor: No

Mailing Address

3620 N Rancho Dr Ste 117

Las Vegas, NV 891303154

Phone: 7252513737

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.