Trujillo, Shannon B

Trujillo, Shannon B is an individual health care provider with primary practice located at 650 W Main St , Farmington NM 87401-8445. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Trujillo, Shannon B can be contacted via phone (505) 787-2616.

Contact Information

Primary practice address
650 W Main St Farmington NM 87401-8445
Phone: (505) 787-2616
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0089231 New Mexico
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CCMH0197421 New Mexico

Profile Details

NPI number 1598997876
LBN Legal business name Trujillo, Shannon B
Credentials LPCC, LADAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2009
Last updated Sep 19th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598997876 NPPES
New Mexico MEDICAID 40803520

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