Andrea Trujillo I

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

License

20131063992 Issued in NV

Practice address

3020 E Bonanza Suite 160-a
Las Vegas, NV 89101

Phone

(702) 771-9128

Fax

(702) 982-3069

NPI assigned

Feb 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• 1St Choice Care LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1023620333
  NPD Authorized official

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1801211891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E BONANZA RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891013702",
            "telephone_number": "702-771-9128",
            "fax_number": "702-982-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 E BONANZA SUITE 160-A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89101",
            "telephone_number": "702-771-9128",
            "fax_number": "702-982-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "ANDREA",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NV",
            "license": "20131063992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46-1989499",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Odaylis Trujillo Ruiz
• Anna Trujillo-Defronzo, MFT-INTERN
• Felicia Trujillo-Lopez
• Marelynn Astrid Trujillo-Zavala
• Adam Bartholomew Trujillo, MD
• Athena Trujillo, LMSW
• Bernardo Trujillo
• Elizabeth Trujillo, DPT
• Gail Trujillo
• Gisselle Trujillo

• Adult Development & Aging Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Adult Development & Aging Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.