Individual
CORY CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2421 PORTOLA RD, VENTURA, CA 93003-8046
(805) 339-2654
(858) 649-6012
Mailing address
224 COOK DR, FILLMORE, CA 93015-1522
(805) 914-9976
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/28/2017
Last updated
12/13/2022
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