Individual
ELENA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHS II
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 525-5079
Mailing address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-7339
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
CASE MANAGER
CA
Enumeration date
03/16/2007
Last updated
05/19/2025
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