Tina Marie Carrillo

NPI #1164311411 in Mentone, California

Provider Information

NPI Number: 1164311411
Entity Type: Individual
Name: Tina Marie Carrillo
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 1, 2025
Last Updated: Jul 1, 2025

Practice Location

Address: 1267 AMETHYST AVE
City: Mentone
State: California
ZIP Code: 92359-9716
Phone: (909) 588-8864

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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