Individual
DR. CARMENITA JILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7707 AUSTIN RD, STOCKTON, CA 95215-8312
(209) 467-2500
Mailing address
153 W INVITAR LN, MOUNTAIN HOUSE, CA 95391-2036
(510) 415-4038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY31243
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/25/2008
Last updated
09/06/2023
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