Kenny Junior Rodriguez Trujillo

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-IJQGWM Issued in CA

Practice address

250 Bon Air Road, Unit B - 1St Floor (Access Team)
Greenbrae, CA 94904

Phone

(888) 818-1115

NPI assigned

Jan 25, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Marin

  • Community/Behavioral Health Agency
  • Greenbrae, CA
  • NPI 1962839803
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1003406810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BON AIR ROAD, UNIT B - 1ST FLOOR (ACCESS TEAM)",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "888-818-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR ROAD, UNIT B - 1ST FLOOR (ACCESS TEAM)",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "888-818-1115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1335 N Dutton Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954014609",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ TRUJILLO",
        "first_name": "KENNY",
        "middle_name": "JUNIOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "MPSS-IJQGWM",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "MPSS-IJQGWM",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-IJQGWM",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert S. Ferretti
• Scott Robinson, M.D.
• Jerrad William Roby, DO
• Alexandra Rochman, PA-C
• Julie Roddy, MA
• Christian Carter Rohde, DDS
• Romeo C. Agbayani Jr MD a Professional Medical Corporation
• Rachel Roomian
• Saul E Rosenberg, PH.D.
• Cristy Walker Roskelley, MFT

• Peer Specialist in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.