Individual
LISA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4332 MAJESTIC PRINCE WAY, ROSEVILLE, CA 95747-9627
(650) 452-8434
Mailing address
8 WILSHIRE CT, DALY CITY, CA 94015-1038
(650) 452-8434
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
738171
CA
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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