Provider Demographics
NPI:1063903698
Name:TRUJILLO, OCEANA (SEP, CMT)
Entity type:Individual
Prefix:
First Name:OCEANA
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:SEP, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5768 RANCHO HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-3402
Mailing Address - Country:US
Mailing Address - Phone:619-395-7291
Mailing Address - Fax:
Practice Address - Street 1:5768 RANCHO HILLS DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92139-3402
Practice Address - Country:US
Practice Address - Phone:619-395-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor