Healthcare Provider Details

I. General information

NPI: 1023927779
Provider Name (Legal Business Name): TIFINY PAULINE TRUJILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11275 HIGHLINE DR
NORTHGLENN CO
80233-3076
US

IV. Provider business mailing address

1870 W 122ND AVE STE 100
WESTMINSTER CO
80234-2075
US

V. Phone/Fax

Practice location:
  • Phone: 303-287-7270
  • Fax: 303-853-4778
Mailing address:
  • Phone: 303-287-7270
  • Fax: 303-853-4778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: