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NPI Code Detail

MEDICARE: ELIZABETH PATRICIA GROSEL

MEDICARE:   ELIZABETH PATRICIA GROSEL
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1558299065
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH PATRICIA GROSEL
Provider Business Mailing Address
First Line : 1522 PRINCE ST APT F
Second Line :
City : BERKELEY
State : CA
Zip : 94703-2349
Country : US
Telephone Number : 480-404-0183
Fax Number :
Provider Business Practice Location Address
First Line : 1521 UNIVERSITY AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94703-1422
Country : US
Telephone Number : 510-981-5249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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Directions to “ ELIZABETH PATRICIA GROSEL ” Practice Location

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