Healthcare Provider Details

I. General information

NPI: 1316403363
Provider Name (Legal Business Name): AMBER S TRUJILLO CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 N LITCHFIELD RD STE 120
GOODYEAR AZ
85395-7805
US

IV. Provider business mailing address

7010 E CHAUNCEY LN STE 225
PHOENIX AZ
85054-3117
US

V. Phone/Fax

Practice location:
  • Phone: 480-585-5200
  • Fax: 480-585-5200
Mailing address:
  • Phone: 480-585-5200
  • Fax: 480-585-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number322329
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN212818
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: