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NPI Code Detail

MEDICARE: MRS. JAIME ALLISON CARRILLO LCSW, MSW, MPH

MEDICARE: MRS. JAIME ALLISON CARRILLO LCSW, MSW, MPH
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
11041C0700XClinical Social WorkerLCSW61177CA

General Provider Information

NPI Number : 1699935809
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAIME ALLISON CARRILLO LCSW, MSW, MPH
Provider Business Mailing Address
First Line : 2100 GENG RD STE 210
Second Line :
City : PALO ALTO
State : CA
Zip : 94303-3307
Country : US
Telephone Number : 833-646-3243
Fax Number :
Provider Business Practice Location Address
First Line : 2100 GENG RD STE 210
Second Line :
City : PALO ALTO
State : CA
Zip : 94303-3307
Country : US
Telephone Number : 833-646-3243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2008
Last Update Date : 03/30/2021

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