Provider Demographics
NPI:1083374847
Name:TRONSTAD, ERIK RAY
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:RAY
Last Name:TRONSTAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-3937
Mailing Address - Country:US
Mailing Address - Phone:925-432-4118
Mailing Address - Fax:
Practice Address - Street 1:555 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-3937
Practice Address - Country:US
Practice Address - Phone:925-432-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator