Provider Demographics
NPI:1306675582
Name:TREJO, ANYSSA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANYSSA
Middle Name:
Last Name:TREJO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12302 ABNEY DR APT D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4834
Mailing Address - Country:US
Mailing Address - Phone:915-588-6333
Mailing Address - Fax:
Practice Address - Street 1:700 SE INNER LOOP
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7700
Practice Address - Country:US
Practice Address - Phone:512-819-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1169479363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health