Individual
DR. CARMEN DE LLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
815 3RD AVE STE 107, CHULA VISTA, CA 91911-1308
(619) 584-6299
(833) 262-7523
Mailing address
14226 OAK SHADOWS, SAN ANTONIO, TX 78232-4419
(619) 847-5100
(833) 262-7523
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11154
CLINICAL PHYCHOLOGY
CA
05
—
PSY 11154/1
—
CA
Enumeration date
05/28/2006
Last updated
05/20/2024
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