Individual
BENJAMIN RAY CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 S EL DORADO ST, STOCKTON, CA 95206-2000
(209) 460-0429
(209) 460-0428
Mailing address
1700 S EL DORADO ST, STOCKTON, CA 95206-2000
(209) 460-0429
(209) 460-0428
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/07/2008
Last updated
04/07/2008
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