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NPI Code Detail

MEDICARE: MS. VICTORIA CARRILLO

MEDICARE: MS. VICTORIA CARRILLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1144035676
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICTORIA CARRILLO
Provider Business Mailing Address
First Line : 2015 WYOMING BLVD NE STE J
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-2646
Country : US
Telephone Number : 505-226-4359
Fax Number :
Provider Business Practice Location Address
First Line : 2051 WYOMING BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-2615
Country : US
Telephone Number : 505-226-4359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2025
Last Update Date : 04/10/2026

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Directions to “ MS. VICTORIA CARRILLO ” Practice Location

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