Stephanie Bain

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Berkeley, CA

NPI 1891344974 · NPPES record last updated Sep 10, 2019

Key facts

NPI
1891344974
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
2712 Telegraph Ave
Berkeley, CA 94705-1117
Phone
(510) 548-8283
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Center for Human Growth Past
since Oct 1, 2023
Accepting new patients
Pacific Center for Human Growth Past
since Sep 15, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

2712 Telegraph Ave
Berkeley, CA 94705-1117

Mailing address

306 Lee St Apt 301
Oakland, CA 94610-4346
Phone (510) 219-7504

Electronic endpoints

TypeEndpointUseAffiliation
Other URL n/a Direct

Other providers in Berkeley, CA

All providers in Berkeley, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.