Individual provider Active NPI

Carlen M Trujillo

  • Rehabilitation Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1487812277
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
9500 Etiwanda Ave
Rancho Cucamonga, CA 91739-9662
Phone
(909) 463-5080
Fax
(909) 463-5233
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

9500 Etiwanda Ave
Rancho Cucamonga, CA 91739-9662

Mailing address

268 W Hospitality LN Ste 400
San Bernardino, CA 92415-0001
Phone (909) 463-5080

Other practice location 1

20 Antelope Blvd
Red Bluff, CA 96080-2807
Phone (530) 567-7600

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1487812277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W HOSPITALITY LN STE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150001",
            "telephone_number": "909-463-5080",
            "fax_number": "909-463-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 ETIWANDA AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399662",
            "telephone_number": "909-463-5080",
            "fax_number": "909-463-5233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Antelope Blvd",
            "address_purpose": "LOCATION",
            "city": "Red Bluff",
            "state": "CA",
            "postal_code": "960802807",
            "country_code": "US",
            "telephone_number": "530-567-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "CARLEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.