Provider Demographics
NPI:1427664820
Name:CARRILLO, ROCIO (PSYD, PPS)
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:PSYD, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1984
Mailing Address - Country:US
Mailing Address - Phone:626-945-2283
Mailing Address - Fax:
Practice Address - Street 1:3907 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1984
Practice Address - Country:US
Practice Address - Phone:626-945-2283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool