Provider Demographics
NPI:1932243268
Name:TRUJILLO, PRISCILLA MARIE (BS, CACII)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:MARIE
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:BS, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2436
Mailing Address - Country:US
Mailing Address - Phone:303-329-9097
Mailing Address - Fax:303-377-1234
Practice Address - Street 1:1470 CHERRY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2436
Practice Address - Country:US
Practice Address - Phone:303-329-9097
Practice Address - Fax:303-377-1234
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health