Healthcare Provider Details

I. General information

NPI: 1760339154
Provider Name (Legal Business Name): DANIELLE J TRUJILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 TULLY RD STE B8
MODESTO CA
95350-0848
US

IV. Provider business mailing address

3300 TULLY RD STE B8
MODESTO CA
95350-0848
US

V. Phone/Fax

Practice location:
  • Phone: 209-416-4866
  • Fax:
Mailing address:
  • Phone: 209-416-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: