Individual
JENNIFER CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 UNIVERSITY DR, ATHLETIC DEPARTMENT, ALISO VIEJO, CA 92656-8081
(310) 409-5050
Mailing address
26531 VIA SACRAMENTO # A, #A, CAPISTRANO BEACH, CA 92624-1338
(310) 409-5050
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/11/2006
Last updated
02/09/2017
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