Trauma & Stress Recovery, a Medical Group Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

TRAUMA & STRESS RECOVERY, A MEDICAL GROUP INC.

Doing business as

Trauma & Stress Recovery Center

Practice address

500 12TH St Ste 110
Oakland, CA 94607-4005

Phone

(415) 346-8640

Fax

(415) 563-2273

NPI assigned

Jul 20, 2020

Last updated

Jul 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christian Asuelo

Title

Practice Administrator

Phone

(415) 346-8640

Specialties & licenses 5

Addresses

Other names 1

• Trauma & Stress Recovery Center Doing business as

Electronic endpoints 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerome C Hall, M.D.

  • Orthopaedic Surgery Physician
  • San Diego, CA
  • NPI 1962425777
  NPD
• Daniel Doi

  • Student in an Organized Health Care Education/Training Program
  • Vallejo, CA
  • NPI 1326494436
  NPD (past)
• Simon Nathan Ferber, PSYD

  • Clinical Psychologist
  • Oakland, CA
  • NPI 1093193914
  NPD (past)
• Consuelo Flores, PSY D

  • Rehabilitation Psychologist
  • Walnut Creek, CA
  • NPI 1982965091
  NPD (past)
• Shery Peimanizar

  • Psychologist
  • Tarzana, CA
  • NPI 1750835229
  NPD (past)
• Erik Thomas Sowder, PH.D.

  • Cognitive & Behavioral Psychologist
  • San Francisco, CA
  • NPI 1366770703
  NPD (past)
• Duy D. Vu, PSY.D.

  • Clinical Psychologist
  • San Rafael, CA
  • NPI 1194031872
  NPD (past)
• Bryan Sang Hyuk Nelson, PSYD

  • Clinical Psychologist
  • Portland, OR
  • NPI 1568718757

  Counselor

  NPD (past)

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1528676269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 12TH ST STE 110",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074005",
            "telephone_number": "415-346-8640",
            "fax_number": "415-563-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 12TH ST STE 110",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074005",
            "telephone_number": "415-346-8640",
            "fax_number": "415-563-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Broadway Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941111423",
            "country_code": "US",
            "telephone_number": "415-346-8640",
            "fax_number": "415-563-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14860 Roscoe Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Panorama City",
            "state": "CA",
            "postal_code": "914024683",
            "country_code": "US",
            "telephone_number": "415-346-8640",
            "fax_number": "415-563-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Bel Marin Keys Blvd Ste B6",
            "address_purpose": "LOCATION",
            "city": "Novato",
            "state": "CA",
            "postal_code": "949495707",
            "country_code": "US",
            "telephone_number": "415-346-8640",
            "fax_number": "415-563-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRAUMA & STRESS RECOVERY, A MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "ASUELO",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "415-346-8640"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christian.asuelo@traumastress.org",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "address_1": "500 12th St Ste 110",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946074005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Trauma & Stress Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.