Healthcare Provider Details

I. General information

NPI: 1386568988
Provider Name (Legal Business Name): MURRIETA 24325, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24325 WASHINGTON AVE
MURRIETA CA
92562-9702
US

IV. Provider business mailing address

1750 BLANKENSHIP RD STE 130
WEST LINN OR
97068-5104
US

V. Phone/Fax

Practice location:
  • Phone: 951-387-8410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: ANA TRUJILLO
Title or Position: ACCOUNTS RECEIVABLE MEDICAID
Credential:
Phone: 503-536-1287