Provider Demographics
NPI:1902541147
Name:FIORILLO, JAMES PATRICK
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:FIORILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:FIORILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10981 SAN DIEGO MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2448
Mailing Address - Country:US
Mailing Address - Phone:619-521-9569
Mailing Address - Fax:
Practice Address - Street 1:10981 SAN DIEGO MISSION RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2448
Practice Address - Country:US
Practice Address - Phone:619-521-9569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health