MEDICARE: DR. AMELIA TRUJILLO PHD, LMFT, PMH-C

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
1	101Y00000X	Counselor
2	106H00000X	Marriage & Family Therapist	0189251	NM

General Provider Information

NPI Number	:	1235577735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMELIA TRUJILLO PHD, LMFT, PMH-C

Provider Business Mailing Address
First Line	:	PO BOX 192
Second Line	:
City	:	JEMEZ SPRINGS
State	:	NM
Zip	:	87025-0192
Country	:	US
Telephone Number	:	505-263-4184
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 192
Second Line	:
City	:	JEMEZ SPRINGS
State	:	NM
Zip	:	87025-0192
Country	:	US
Telephone Number	:	505-263-4184
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	07/15/2025

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