Individual
ANGELIQUE CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15373 INNOVATION DR STE 170, SAN DIEGO, CA 92128-3427
(858) 723-8938
Mailing address
PO BOX 740780, ATLANTA, GA 30374-0780
(855) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
2355S0801X
Speech-Language Assistant
—
—
Other
Enumeration date
03/30/2018
Last updated
05/26/2026
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