BREANNA TRUJILLO (NPI# 1215470695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215470695 |
| Entity Type | Individual |
| Full Name | BREANNA TRUJILLO |
| Practice Address |
905 N Gurley Ave Gillette WY 82716-2109 |
| Practice Telephone | 3076860669 |
| Mailing Telephone | 3076860669 |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 830230126 | 05 |
| Street Address |
905 N GURLEY AVE |
| City | GILLETTE |
| State | WY |
| Zip Code | 82716-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063890341 | Scott Clem | Residential Treatment Facility, Emotionally Disturbed Children | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2015-05-07 |
| 1154948040 | Kiley Myers | Social Worker | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2020-06-26 |
| 1750941464 | Jessica Sue Jaycox | Social Worker | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2019-06-14 |
| 1679047922 | Amy Darlene Weber | Counselor | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2019-01-18 |
| 1336640606 | Erin Urbanoski | Social Worker | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2018-02-22 |
| 1780183970 | Jennifer Gauthier Felion | Counselor | 905 N Gurley Ave, Gillette, WY 82716 | 2018-02-02 |
| 1154829414 | Karla Jo Rosario | Case Manager/Care Coordinator | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2018-01-31 |
| 1902316573 | Amber Friedlan | Counselor | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2017-10-09 |
| 1114443108 | Trey Jodozi | Case Manager/Care Coordinator | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2017-08-21 |
| 1811424500 | Johnny Neal II | Case Manager/Care Coordinator | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2017-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053822387 | Diana Lynn Ohman | Dietitian, Registered | 709 West Eighth Street, Suite 4, Gillette, WY 82716 | 2017-10-13 |
| 1821457821 | Courage To Change Counseling LLC | Community/Behavioral Health | 113 S. Gillette Ave, Gillette, WY 82716 | 2016-02-18 |
| 1003290594 | Kris Huber | Community/Behavioral Health | 905 Gurley Ave, Gillette, WY 82716 | 2015-07-14 |
| 1649516857 | Shirley L Haley | Nurse Practitioner | 1304 West 4th Street, Gillette, WY 82716 | 2012-12-14 |
| 1174867188 | Rebecca J Mader | Registered Nurse | 501 South Burma Ave., Gillette, WY 82716 | 2012-11-15 |
| 1568728228 | Kerry Elizabeth Warner | Registered Nurse | 201 S Burma Ave, Gillette, WY 82716 | 2012-04-07 |
| 1720363351 | Julie Ann Faldalen | Licensed Practical Nurse | 501 South Burma, Gillette, WY 82716 | 2011-10-14 |
| 1083937486 | Clear Creek Counseling LLC | Counselor | 801 E. 4th St., Suite 24, Gillette, WY 82716 | 2010-03-12 |
| 1821241423 | Dianna L Knox | Counselor | 500 S Burma Ave, Gillette, WY 82716 | 2008-10-28 |
| 1588826887 | Scott R Hunter | Chiropractor | 439 Prairie View Place Ste D, Dr S R Hunter, Gillette, WY 82716 | 2008-06-27 |
| Find all providers in zip 82716 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169128 | Jodi Thornhill | Day Training, Developmentally Disabled Services | 900 Camel Dr. Ste. Gg, Pmb #154, Gillette, WY 82716-4974 | 2020-06-17 |
| 1366910770 | Haley D Gray | Day Training, Developmentally Disabled Services | 3800 Overdale Dr, Gillette, WY 82718-7633 | 2018-11-05 |
| 1902298029 | Jena Cowen | Day Training, Developmentally Disabled Services | 5305 Cowen Drive, Gillette, WY 82718 | 2015-02-26 |
| 1972899623 | Kathryn Spring Wilkins | Day Training, Developmentally Disabled Services | 4401 Chancery Ln, Gillette, WY 82718-7725 | 2011-06-21 |
| 1548568710 | Amanda M Coleman Koester | Day Training, Developmentally Disabled Services | 302 S Osborne Ave, Gillette, WY 82716-3940 | 2011-03-11 |
| 1083948483 | Linda Barbour | Day Training, Developmentally Disabled Services | 738 Collins Rd, Gillette, WY 82716-8802 | 2009-10-01 |
| 1831389584 | Sol Domus, Inc. | Day Training, Developmentally Disabled Services | 2805 Cedar Ave Ste B, Gillette, WY 82718-2000 | 2007-07-30 |
| 1821449398 | Karissa Morris | Day Training, Developmentally Disabled Services | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2016-06-27 |
| 1629426796 | Ashley Simonson | Day Training, Developmentally Disabled Services | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2016-05-31 |
| 1750749560 | Catherine Hadley | Day Training, Developmentally Disabled Services | 905 N Gurley Ave, Gillette, WY 82716-2109 | 2016-02-08 |
| Find all providers in GILLETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.