Individual ProviderTracy Rae IsaacCounselorBehavioral Health & Social Service ProvidersPractice Address239 W 9th St, Upland, CA 91786-5979(909) 981-6121(909) 906-9844PECOS EnrollmentBased on the most recent information from CMS, provider Tracy Rae Isaac does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1023555158Provider TypeIndividualFull NameIsaac, Tracy RaeTitleMs.CredentialLPHA, APCC, CATC IVGenderFemaleSole ProprietorNoEnumeration Date1/26/2017Last Updated4/10/2024Contact InformationPractice LocationPractice Address239 W 9th St, Upland, CA 91786-5979Phone(909) 981-6121FaxUnlisted FaxMailing LocationMailing Address3286 E Guasti Rd Ste 100, Ontario, CA 91761-8646Phone(909) 906-9844FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense12043CaliforniaCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseR1213110915California