TRAUMA & STRESS RECOVERY, A MEDICAL GROUP INC. (NPI# 1528676269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528676269 |
| Entity Type | Organization |
| Organization Name | TRAUMA & STRESS RECOVERY, A MEDICAL GROUP INC. |
| Practice Address |
500 12th St Ste 110 Oakland CA 94607-4005 |
| Practice Telephone | 4153468640 |
| Practice Fax Number | 4155632273 |
| Mailing Telephone | 4153468640 |
| Mailing Fax Number | 4155632273 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-28 |
| Authorized Official Name | CHRISTIAN ASUELO (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 4153468640 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Trauma & Stress Recovery Center | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14860 Roscoe Blvd Ste 200, Panorama City, CA 914024683 | 4153468640 | 4155632273 |
| 250 Bel Marin Keys Blvd Ste B6, Novato, CA 949495707 | 4153468640 | 4155632273 |
| 75 Broadway Ste 202, San Francisco, CA 941111423 | 4153468640 | 4155632273 |
| Street Address |
500 12TH ST STE 110 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94607-4005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568718757 | Bryan Sang Hyuk Nelson | Counselor | 500 12th St Ste 110, Oakland, CA 94607-4005 | 2012-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990832 | Casey Domine | Nurse Practitioner | 1750 10th St., Apt. A, Oakland, CA 94607 | 2020-10-21 |
| 1992303226 | Sonia Maria Sui Ying Poon Harris | Pharmacist | 388 9th Street Ste 108, Oakland, CA 94607 | 2020-10-09 |
| 1962029595 | Yuan Yan | Student in an Organized Health Care Education/Training Program | 310 8th Street, Suit 210 Asian Health Services: Special, Oakland, CA 94607 | 2020-06-30 |
| 1093339962 | Alameda County Probation Department | Case Manager/Care Coordinator | 1111 Jackson St., Oakland, CA 94607 | 2020-06-05 |
| 1053947812 | Deanna Karraa | Registered Nurse | 1111 Jackson 6th Floor, Oakland, CA 94607 | 2020-03-12 |
| 1952942575 | Roots Community Health Center | Family Medicine | 583 5th St Ste A, Oakland, CA 94607 | 2019-10-04 |
| 1568927994 | Lynsey Scott | Counselor | Wiley Manuel Courthouse, 661 Washington St Rm223, Oakland, CA 94607 | 2019-02-11 |
| 1366930182 | Options Recovery Services | Community/Behavioral Health | 614 Alice St, Oakland, CA 94607 | 2018-04-26 |
| 1255845640 | Adrienne My-tram Nguyen, Dds - Inc | Dentist | 475 8th Street, Oakland, CA 94607 | 2017-11-22 |
| 1912422528 | Maria H Cho | Registered Nurse | 2511 Market St, Oakland, CA 94607 | 2017-08-04 |
| Find all providers in zip 94607 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932727906 | Carolina Bacchi Psychotherapy and Psychoanalysis, LLC | Psychologist | 5665 College Ave Ste 340c, Oakland, CA 94618-1658 | 2020-07-07 |
| 1558990770 | Laurie Jean Patraitis | Psychologist | 419 30th St Ste 3, Oakland, CA 94609-3374 | 2020-04-08 |
| 1194354001 | Lyndsay Dell | Psychologist | 4420 Penniman Ave Apt C, Oakland, CA 94619-2659 | 2020-04-02 |
| 1619513223 | Lesley A Parke | Psychologist | 445 Bellevue Ave Ste 302, Oakland, CA 94610-4923 | 2019-11-19 |
| 1700437233 | Laurette Schiff Gennis | Psychologist | 5655 College Ave Ste 315b, Oakland, CA 94618-1669 | 2019-09-25 |
| 1477112522 | Paul A Jackson | Psychologist | 459 W Macarthur Blvd, Oakland, CA 94609-2808 | 2019-06-12 |
| 1184287435 | Unfold Psychology: A. Heafey Practice | Psychologist | 1955 Mountain Blvd., Suite 101, Oakland, CA 94611 | 2019-04-22 |
| 1689173759 | Bay Psychology Group Inc | Psychologist | 5297 College Ave Ste 103, Oakland, CA 94618-1462 | 2018-02-05 |
| 1861925034 | Sarah Carroll | Psychologist | 5757 Morse Dr, Oakland, CA 94605-1137 | 2017-04-05 |
| 1679026991 | Jessica Bol | Psychologist | 5327 College Ave Ste 1, Oakland, CA 94618-1416 | 2016-08-03 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.