Active NPI
Crystal Trujillo
- Behavior Analyst
- San Dimas, CA
National Provider Identifier
1265932107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-58047
- Practice address
- 1212 N San Dimas Canyon Rd
San Dimas, CA 91773-1223 - Phone
- (626) 628-1204
- NPI assigned
- Feb 16, 2018
- Last updated
- May 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-58047 | CA | Primary |
Addresses
Primary practice location
1212 N San Dimas Canyon Rd
San Dimas, CA 91773-1223
Mailing address
2151 E Convention Center Way Ste 103
Ontario, CA 91764-5449
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1265932107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 E CONVENTION CENTER WAY STE 103",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917645449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 N SAN DIMAS CANYON RD",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917731223",
"telephone_number": "626-628-1204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-16",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-22-58047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Dimas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.