Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 95003495 | CA |
NPI | 1023476397 |
---|---|
Provider Name | Celina Trujillo |
First Address | Sacramento, CA 95821-2123 |
Second Address | Sacramento, CA 95821-2123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2016 |
Last Update Date | 02/02/2016 |