Individual provider Active NPI

Elizabeth Anne Trachtenberg, PH.D.

  • Ph.D. Medical Genetics
  • Oakland, CA
National Provider Identifier
1215095864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
DRK24 Issued in CA
Practice address
747 52ND St
Childrens Hospital Oakland, Blmrb Ste 204
Oakland, CA 94609-1809
Phone
(510) 450-7685
Fax
(510) 450-5692
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X DRK24 CA Primary

Addresses

Primary practice location

747 52ND St
Childrens Hospital Oakland, Blmrb Ste 204
Oakland, CA 94609-1809

Mailing address

2960 Benvenue Ave
Berkeley, CA 94705-2231
Phone (510) 665-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DRK24CAMDPh.D. Medical Genetics

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215095864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 BENVENUE AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052231",
            "telephone_number": "510-665-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "address_2": "CHILDRENS HOSPITAL OAKLAND, BLMRB STE 204",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-450-7685",
            "fax_number": "510-450-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACHTENBERG",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "CA",
            "license": "DRK24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.