TRACY L. HARRIS NPI 1073546081

NPI Information

  • NPI: 1073546081
  • Provider Name: TRACY L. HARRIS
  • Classification: Hospice Care, Community Based - 251G00000X
  • Entity Type: Organization
  • Doing Business As: AVALON HOSPICE & PALLIATIVE CARE
  • CLIA Number: 05D1048350
  • Address: 3914 MURPHY CANYON RD
    SUITE # A226
    SAN DIEGO, CA
    ZIP 92123
  • Phone: (858) 751-0315

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NPI Details

TRACY L. HARRIS is a hospice care community based in San Diego, CA. TRACY L. HARRIS NPI is 1073546081. The provider is registered as an organization entity type.
The provider Is Doing Business As Avalon Hospice & Palliative Care.

The provider's business location address is:

3914 MURPHY CANYON RD
SUITE # A226
SAN DIEGO, CA
ZIP 92123-491
Phone: (858) 751-0315
Fax: (858) 560-0435

The provider's authorized official is Tracy Lynn Harris .
The authorized official title is Administrator/ceo and has the following contact phone number (858) 751-0315.

The CLIA number assigned to this NPI record is 05D1048350 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 6/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251G00000XHospice Care, Community Based550000104CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
105-1791MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE PROVIDER NO
2HPC01791FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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