Individual
CHRISTIAN JOSE ANTONIO CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2420 KLEIN RD, SAN JOSE, CA 95148-1801
(408) 440-6115
Mailing address
2420 KLEIN RD, SAN JOSE, CA 95148-1801
(408) 440-6115
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
CA
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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