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NPI Code Detail

MEDICARE: MISA TROTMAN LCSW

MEDICARE: MISA TROTMAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW 20625CA

General Provider Information

NPI Number : 1174724090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISA TROTMAN LCSW
Provider Business Mailing Address
First Line : 2710 CROW CANYON RD # 1074
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-1606
Country : US
Telephone Number : 925-263-9592
Fax Number :
Provider Business Practice Location Address
First Line : 777 DAVIS ST STE 300
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-6923
Country : US
Telephone Number : 510-468-1225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 01/12/2025

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