Active NPI
Robert Trujillo, PH.D
- Clinical Psychologist
- San Marino, CA
National Provider Identifier
1497833891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY10273
- Practice address
- 2400 Mission St
209
San Marino, CA 91108-1632 - Phone
- (626) 403-7400
- Fax
- (626) 585-8892
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY10273 | CA | Primary |
Addresses
Primary practice location
2400 Mission St
209
San Marino, CA 91108-1632
Mailing address
2400 Mission St
209
San Marino, CA 91108-1632
Phone (626) 403-7400
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY10273 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497833891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 MISSION ST",
"address_2": "209",
"city": "SAN MARINO",
"state": "CA",
"postal_code": "911081632",
"telephone_number": "626-403-7400",
"fax_number": "626-585-8892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 MISSION ST",
"address_2": "209",
"city": "SAN MARINO",
"state": "CA",
"postal_code": "911081632",
"telephone_number": "626-403-7400",
"fax_number": "626-585-8892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY10273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Marino, CA
- The Huntington Medical Foundation
- Tin-Hoang Nguyen D.D.S., Inc.
- Roberto Tostado, MD
- Teresa Avendano Tostado, NP
- Total Potential Physical Therapy: Wellness & Rehabilitation, PC
- Judy Tung, MHS, PA-C
- Christine Tzeng, COTA
- Van Nuys Diagnostic Services, Inc.
- Vision Institute of Southern California a Professional Medical Corpora
- Karl Friedrich Vontiehl, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.