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General NPI Number Information
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NPI Number | 1336460633
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Entity Type | Individual
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Provider Name | ASHLEY B TRUJILLO MPT
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Gender | Male
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 101 HODENCAMP RD SUITE 102
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5836
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Country | US
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Telephone | 805-496-9944
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Fax | 805-496-9945
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Provider Business Mailing Address
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Address Line | 101 HODENCAMP RD SUITE 102
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5836
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Country | US
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Telephone | 805-496-9944
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Fax | 805-496-9945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 36228
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License Number State | CA
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