DR. TRACY WUTZKE PSY.D.
NPI 1841415122
Psychologist in San Diego, CA

Active since April 13, 2007Opted out of Medicare · through Jan 23, 2028
9888 CARROLL CENTRE RD STE 216, SAN DIEGO, CA 92126(858) 413-7557 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 29, 2021, Dec 17, 2020 (2 updates tracked since 2020).

About Dr. Tracy Wutzke Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TRACY WUTZKE PSY.D. (NPI 1841415122) is an individual psychologist in San Diego, California, licensed in California (PSY17239) and active in the NPI registry since April 2007. She has opted out of Medicare through January 23, 2028.

NPPES Registry Identity

NPI1841415122
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. TRACY WUTZKECredential: PSY.D.
Location Address9888 CARROLL CENTRE RD STE 216San Diego, CA 92126-4515
Mailing Address9888 Carroll Centre Rd Ste 216San Diego, CA 92126-4515 · (858) 413-7557
Sole ProprietorYes
Enumeration DateApril 13, 2007
Last NPPES UpdateNovember 29, 20212 updates tracked since enumeration
NPPES CertifiedNovember 14, 2021
NPI 1841415122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY17239
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY17239 (CA)
9888 CARROLL CENTRE RD STE 216, San Diego, CA 92126

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Tracy Wutzke Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 23, 2024 through January 23, 2028.

Opt-Out Effective DateJanuary 23, 2024
Opt-Out In Effect ThroughJanuary 23, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Psychologist (Clinical)
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Marriage & Family Therapist
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Psychologist (Clinical)
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Psychologist (Clinical)
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Psychologist (Clinical)
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Marriage & Family Therapist
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126
Counselor (Mental Health)
9888 CARROLL CENTRE RD STE 216
SAN DIEGO, CA 92126

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracy Wutzke's NPI number?

The NPI number for Tracy Wutzke is 1841415122. It was assigned to this individual provider in the NPPES registry on April 13, 2007.

Where is Tracy Wutzke located?

Tracy Wutzke practices at 9888 Carroll Centre Rd Ste 216, San Diego, CA 92126. The listed phone number is (858) 413-7557.

What is Tracy Wutzke's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Tracy Wutzke enrolled in Medicare?

No. Tracy Wutzke has opted out of Medicare through January 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Tracy Wutzke was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.