Healthcare Provider Details

I. General information

NPI: 1073804910
Provider Name (Legal Business Name): JOHN TROJANOWSKI PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2011
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SHATTUCK AVE STE 12-216
BERKELEY CA
94709-1411
US

IV. Provider business mailing address

1400 SHATTUCK AVE STE 12-216
BERKELEY CA
94709-1411
US

V. Phone/Fax

Practice location:
  • Phone: 510-239-7024
  • Fax:
Mailing address:
  • Phone: 510-239-7024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: