Traci Lynn Derr, HHP, CMT
Massage Therapist in Santee, CA. Individual provider (NPI-1).
NPI number1669847448
StatusActive
Last updated in NPPESSep 21, 2021
Details
- NPI
- 1669847448
- Entity type
- Individual (NPI-1)
- Name
- Miss Traci Lynn Derr
- Credential
- HHP, CMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 5, 2015
- Certification date
- Sep 21, 2021
- Last updated
- Sep 21, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 61672 | CA | Yes |
Practice location
8528 N Magnolia Ave Ste 102Santee, CA 92071-4692
Phone 619-972-8650
Mailing address
8528 N Magnolia Ave Ste 102Santee, CA 92071-4692
Phone 619-972-8650
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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