Active NPI
Troy Piwowarski, PSYD
- Clinical Psychologist
- Oakland, CA
National Provider Identifier
1902130578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 28839
- Practice address
- 4279 Piedmont Ave
Oakland, CA 94611-4713 - Phone
- (510) 878-4165
- NPI assigned
- Sep 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 28839 | CA | Primary |
Addresses
Primary practice location
4279 Piedmont Ave
Oakland, CA 94611-4713
Mailing address
4279 Piedmont Ave
Oakland, CA 94611-4713
Phone (510) 878-4165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28839 | Other | CA | BOARD OF PSYCHOLOGY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 27, 2023 through Dec 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28839 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546646400000",
"number": "1902130578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4279 PIEDMONT AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946114713",
"telephone_number": "510-878-4165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4279 PIEDMONT AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946114713",
"telephone_number": "510-878-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIWOWARSKI",
"first_name": "TROY",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-29",
"last_updated": "2019-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "28839",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PSYCHOLOGY",
"identifier": "28839",
"state": "CA"
}
],
"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 Jan 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.