Provider Demographics
NPI:1073804910
Name:TROJANOWSKI, JOHN (PSYD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:TROJANOWSKI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SHATTUCK AVE STE 12-216
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1411
Mailing Address - Country:US
Mailing Address - Phone:510-239-7024
Mailing Address - Fax:
Practice Address - Street 1:1425 LEIMERT BLVD STE 300
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1808
Practice Address - Country:US
Practice Address - Phone:510-239-7024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical