Individual
MARIANA S CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S KNOTT AVE APT 3, ANAHEIM, CA 92804-1478
(714) 829-6919
Mailing address
201 S KNOTT AVE APT 3, ANAHEIM, CA 92804-1478
(714) 829-6919
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41292
CA
Other
Enumeration date
01/11/2020
Last updated
01/11/2020
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