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1669213393
JOSE LUIS CARRILLO
HAYWARD, CA
NPI
1669213393
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 15971)
Enumeration Date
2024-06-05
Last Update Date
2024-06-05
Business Address
JOSE LUIS CARRILLO SUDRC
2575 DEPOT RD
HAYWARD, CA 94545-2341
Phone number: 510-784-5874
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Mailing Address
JOSE LUIS CARRILLO SUDRC
2575 DEPOT RD
HAYWARD, CA 94545-2341
Phone number: 510-784-5874
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