Healthcare Provider Details

I. General information

NPI: 1316204985
Provider Name (Legal Business Name): ERLINDA TRUJILLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3097 WILLOW AVE STE 8
CLOVIS CA
93612-4715
US

IV. Provider business mailing address

3097 WILLOW AVE STE 8
CLOVIS CA
93612-4715
US

V. Phone/Fax

Practice location:
  • Phone: 559-396-5567
  • Fax: 884-880-6677
Mailing address:
  • Phone: 559-396-5567
  • Fax: 844-880-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: