Grant Pezeshki

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1348 Virginia St
Berkeley, CA 94702-1467

Phone

(718) 857-8729

NPI assigned

Feb 9, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1972257756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 VIRGINIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021467",
            "telephone_number": "718-857-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 VIRGINIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021467",
            "telephone_number": "718-857-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKI",
        "first_name": "GRANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Petreas, RN, FNP
• Zara Petrosyan
• Pets Partnership
• Lauren Bacall Pettis
• Madison Pettit, AMFT
• Eden Anne Pfeiffer
• Catherine Pfister, L.C.S.W.
• Steve Pham, M.D.
• Richard Phan, OD
• Pharmaca Integrative Pharmacy, Inc.

• Community Health Worker in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.