Individual provider Active NPI

Justin Traille, DC

  • Chiropractor
  • Pleasanton, CA
National Provider Identifier
1710557558
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34762 Issued in CA
Practice address
7051 Commerce Cir Ste B
Pleasanton, CA 94588-8028
Phone
(925) 462-5557
NPI assigned
Jun 24, 2021
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34762 CA Primary

Addresses

Primary practice location

7051 Commerce Cir Ste B
Pleasanton, CA 94588-8028

Mailing address

7051 Commerce Cir Ste B
Pleasanton, CA 94588-8028
Phone (925) 462-5557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220512001282 CA Practitioner - Chiropractic 1759768732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce Chiropractic Corporation Single Specialty CurrentSince Apr 15, 2022 Accepting new patients

Locations

7051 Commerce Cir
Ste B
Pleasanton, CA 94588
Phone (925) 462-5557

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1710557558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 COMMERCE CIR STE B",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888028",
            "telephone_number": "925-462-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 COMMERCE CIR STE B",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888028",
            "telephone_number": "925-462-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAILLE",
        "first_name": "JUSTIN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.