Individual provider Active NPI

Thomas Allen Trujillo Jr., APCC

  • Professional Counselor
  • San Francisco, CA
National Provider Identifier
1710131727
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APCC13690 Issued in CA
Practice address
1625 Carroll Ave
San Francisco, CA 94124-3219
Phone
(415) 468-5100
NPI assigned
Nov 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 480015BP CA
Mental Health Counselor 101YM0800X 00000529 CA
Professional Counselor 101YP2500X APCC13690 CA Primary

Addresses

Primary practice location

1625 Carroll Ave
San Francisco, CA 94124-3219

Mailing address

PO Box 172
Fairfield, CA 94533-0017
Phone (707) 235-7313

Other practice location 1

1735 Enterprise Dr.
Suite #105 Healthy Partnerships Inc.
Fairfield, CA 94533-6440
Phone (707) 425-1799

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

State licenses

LicenseStateTypeSpecialty
480015BPCAMDAddiction (Substance Use Disorder) Counselor
00000529CAMDMental Health Counselor
APCC13690CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1710131727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945330017",
            "telephone_number": "707-235-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 CARROLL AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941243219",
            "telephone_number": "415-468-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1735 Enterprise Dr.",
            "address_2": "Suite #105 Healthy Partnerships Inc.",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945336440",
            "country_code": "US",
            "telephone_number": "707-425-1799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "THOMAS",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "480015BP",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "00000529",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "APCC13690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.