MEDICARE: JENA RENEE TRUJILLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	1046293	TX

General Provider Information

NPI Number	:	1366377517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENA RENEE TRUJILLO

Provider Business Mailing Address
First Line	:	12418 AURORA BASIN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-2674
Country	:	US
Telephone Number	:	907-297-9532
Fax Number	:

Provider Business Practice Location Address
First Line	:	12418 AURORA BASIN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-2674
Country	:	US
Telephone Number	:	907-297-9532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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Directions to “ JENA RENEE TRUJILLO ” Practice Location

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