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1255504668
BENJAMIN RAY CARRILLO
STOCKTON, CA
NPI
1255504668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-04-07
Last Update Date
2008-04-07
Business Address
-- BENJAMIN RAY CARRILLO
1700 S EL DORADO ST
STOCKTON, CA 95206-2000
Phone number: 209-460-0429
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Mailing Address
-- BENJAMIN RAY CARRILLO
1700 S EL DORADO ST
STOCKTON, CA 95206-2000
Phone number: 209-460-0429
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