Provider Demographics
NPI:1518247659
Name:TRUJILLO, RENA (MSW)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 1/2 VIA VIS
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3829
Mailing Address - Country:US
Mailing Address - Phone:323-833-7755
Mailing Address - Fax:
Practice Address - Street 1:308 1/2 VIA VIS
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3829
Practice Address - Country:US
Practice Address - Phone:323-833-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-21
Last Update Date:2011-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker