Provider Demographics
NPI:1699935809
Name:CARRILLO, JAIME ALLISON (LCSW, MSW, MPH)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:ALLISON
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:LCSW, MSW, MPH
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:ALLISON
Other - Last Name:GLOBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 GENG RD STE 210
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3307
Mailing Address - Country:US
Mailing Address - Phone:833-646-3243
Mailing Address - Fax:
Practice Address - Street 1:2100 GENG RD STE 210
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-3307
Practice Address - Country:US
Practice Address - Phone:833-646-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW611771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical