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General NPI Number Information
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NPI Number | 1265747984
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Entity Type | Individual
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Provider Name | JAMILYN D TRILLO LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 6302 THIRTEENTH AVE.
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City | LUCERNE
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State | CA
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Zip | 95458
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Country | US
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Telephone | 707-274-9101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1024
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City | LUCERNE
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State | CA
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Zip | 95458-1024
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Country | US
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Telephone | 707-274-9101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 81537
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW 32505
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW87939
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License Number State | CA
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