TIMOTHY JOSEPH CARRILLO

VISTA, CA
NPI1134472897
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  C1106011523)
Enumeration Date2012-10-18
Last Update Date2012-10-18
Business Address
-- TIMOTHY JOSEPH CARRILLO RAS-C1106011523
504 W VISTA WAY
VISTA, CA 92083-5704
Phone number: 760-940-1836
Mailing Address
-- TIMOTHY JOSEPH CARRILLO RAS-C1106011523
504 W VISTA WAY
VISTA, CA 92083-5704
Phone number: 760-940-1836
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