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NPI Code Detail

MEDICARE: PARTNERSHIPS FOR TRAUMA RECOVERY

MEDICARE: PARTNERSHIPS FOR TRAUMA RECOVERY
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316435886
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARTNERSHIPS FOR TRAUMA RECOVERY
Provider Business Mailing Address
First Line : 2526 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94704-2607
Country : US
Telephone Number : 510-969-2581
Fax Number :
Provider Business Practice Location Address
First Line : 2526 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94704-2607
Country : US
Telephone Number : 510-969-2581
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : DR. GIANINA PELLEGRINI
Credential : PH.D.
Telephone Number : 510-730-2386
Provider Enumeration Date : 04/30/2018
Last Update Date : 08/02/2022

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Directions to “PARTNERSHIPS FOR TRAUMA RECOVERY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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