Individual
KIMBERLY SAMANTA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3433 W SHAW AVE # 107, FRESNO, CA 93711-3229
(559) 374-3990
Mailing address
3433 W SHAW AVE # 107, FRESNO, CA 93711-3229
(559) 374-3990
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
04/06/2026
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