Individual
MS. BERENICE MARTINEZ CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017
(213) 241-3841
(213) 241-3305
Mailing address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017-1466
(213) 241-3841
(213) 241-3305
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
102341
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#95-2633765
MEDI-CAL
CA
Enumeration date
07/20/2011
Last updated
12/01/2021
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