Provider Demographics
NPI:1053509372
Name:MURILLO, ELOISA
Entity Type:Individual
Prefix:MRS
First Name:ELOISA
Middle Name:
Last Name:MURILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43030 NEWPORT DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-6113
Mailing Address - Country:US
Mailing Address - Phone:510-656-4206
Mailing Address - Fax:510-656-0460
Practice Address - Street 1:43030 NEWPORT DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6113
Practice Address - Country:US
Practice Address - Phone:510-656-4206
Practice Address - Fax:510-656-0460
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator