Provider Demographics
NPI:1255068854
Name:TRILLO, STEVEN S JR
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:S
Last Name:TRILLO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PARKMOOR AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3798
Mailing Address - Country:US
Mailing Address - Phone:408-781-9659
Mailing Address - Fax:408-961-9853
Practice Address - Street 1:46 RACE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3130
Practice Address - Country:US
Practice Address - Phone:408-781-9659
Practice Address - Fax:408-961-9853
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator