Provider Demographics
NPI:1588819817
Name:CASTILLO-TRUJILLO, ALICIA CHRISTINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:CHRISTINE
Last Name:CASTILLO-TRUJILLO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10320 HIDDEN OAK DR
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1818
Mailing Address - Country:US
Mailing Address - Phone:818-554-5640
Mailing Address - Fax:
Practice Address - Street 1:3030 TYLER AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3352
Practice Address - Country:US
Practice Address - Phone:626-350-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19991363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical