Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033346515 |
---|---|
Provider Name | Sonia Carrillo |
First Address | Palmdale, CA 93591 |
Second Address | Lancaster, CA 93534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2009 |
Last Update Date | 11/06/2009 |