Provider Demographics
NPI:1871709329
Name:TRUJILLO, TERESE PALAZZO (NP)
Entity type:Individual
Prefix:MS
First Name:TERESE
Middle Name:PALAZZO
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14649 EVENING STAR DR
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-3016
Mailing Address - Country:US
Mailing Address - Phone:858-231-0654
Mailing Address - Fax:858-679-1932
Practice Address - Street 1:1509 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-2315
Practice Address - Country:US
Practice Address - Phone:760-746-1562
Practice Address - Fax:760-746-0711
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA377138OtherREGISTERED NURSE
CA13357OtherNURSE PRACTITIONER CERT.
CA13357OtherNP FURNISHING NO.
CA377138OtherREGISTERED NURSE