| Doctor Name: | TRACIE TEMPLE |
| NPI Number: | 1003120205 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 411 W Seaside Way Unit 1403 Long Beach, CA - 908027988 |
| Business Phone Number: | 5625953099 |
| Business Fax Number: | |
| Mailing Address: | 411 W Seaside Way Unit 1403, LONG BEACH |
| State: | CA |
| Postal Code: | 908027988 |
| Phone Number: | 5625953099 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2010 |
| NPI Last Update Date: | 07/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |