Provider Demographics
NPI:1790853836
Name:TRUJILLO, CLAUDIA JANETH
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:JANETH
Last Name:TRUJILLO
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 1:5670 N FRESNO ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8330
Mailing Address - Country:US
Mailing Address - Phone:559-432-2975
Mailing Address - Fax:
Practice Address - Street 1:5670 N FRESNO ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8330
Practice Address - Country:US
Practice Address - Phone:559-432-2975
Practice Address - Fax:559-432-0728
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist