Healthcare Provider Details

I. General information

NPI: 1942326178
Provider Name (Legal Business Name): LILIA TRUJILLO MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 W VENTURA ST STE 240
FILLMORE CA
93015-1882
US

IV. Provider business mailing address

828 W VENTURA ST STE 240
FILLMORE CA
93015-1882
US

V. Phone/Fax

Practice location:
  • Phone: 805-524-8664
  • Fax: 805-524-8655
Mailing address:
  • Phone: 805-524-8664
  • Fax: 805-524-8655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW 13993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: