MEDICARE: RECELITO TRAU

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1457205072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RECELITO TRAU

Provider Business Mailing Address
First Line	:	8272 MEDEIROS WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-8163
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 MACCORKLE AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1045
Country	:	US
Telephone Number	:	800-995-4682
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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Directions to “ RECELITO TRAU ” Practice Location

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