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NPI Code Detail

MEDICARE: JESUS H TRUJILLO LPC

MEDICARE: JESUS H TRUJILLO LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1194438226
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESUS H TRUJILLO LPC
Provider Business Mailing Address
First Line : 3050 N LAKEHARBOR LN STE 248
Second Line :
City : BOISE
State : ID
Zip : 83703-6281
Country : US
Telephone Number : 208-991-4696
Fax Number : 208-902-3728
Provider Business Practice Location Address
First Line : 3050 N LAKEHARBOR LN STE 248
Second Line :
City : BOISE
State : ID
Zip : 83703-6281
Country : US
Telephone Number : 208-991-4696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2023
Last Update Date : 01/04/2023

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Directions to “ JESUS H TRUJILLO LPC” Practice Location

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