Individual
ANGELICA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2644 30TH ST STE 100, SANTA MONICA, CA 90405-3051
(310) 314-6200
Mailing address
2644 30TH ST STE 100, SANTA MONICA, CA 90405-3051
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
284072
CA
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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