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NPI Code Detail

MEDICARE: VIVIANA TRUJILLO

MEDICARE: VIVIANA TRUJILLO
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
1106E00000XAssistant Behavior Analyst
2103K00000XBehavior Analyst1-21-55617CO

General Provider Information

NPI Number : 1982070496
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIANA TRUJILLO
Provider Business Mailing Address
First Line : 2005 AEROPLAZA DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-4207
Country : US
Telephone Number : 719-425-7771
Fax Number : 719-208-7730
Provider Business Practice Location Address
First Line : 2005 AEROPLAZA DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-4207
Country : US
Telephone Number : 719-425-7771
Fax Number : 719-208-7730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2015
Last Update Date : 12/09/2021

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Directions to “ VIVIANA TRUJILLO ” Practice Location

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