1891051496 NPI number — MRS. ALEJANDRA TRUJILLO GARCIA LMFT

Table of content: MRS. ALEJANDRA TRUJILLO GARCIA LMFT (NPI 1891051496)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891051496 NPI number — MRS. ALEJANDRA TRUJILLO GARCIA LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRUJILLO GARCIA
Provider First Name:
ALEJANDRA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TRUJILLO
Provider Other First Name:
ALEJANDRA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1891051496
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11145 TAMPA AVE STE 15A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHRIDGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91326-2265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-468-7622
Provider Business Mailing Address Fax Number:
818-428-1561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11145 TAMPA AVE STE 15A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91326-2265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-468-7622
Provider Business Practice Location Address Fax Number:
818-428-1561
Provider Enumeration Date:
04/09/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LMFT88039 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)