Provider Demographics
NPI:1730724329
Name:CARRILLO, JOYCE J (MA, PSYD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:J
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:MA, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3728
Mailing Address - Country:US
Mailing Address - Phone:626-429-6448
Mailing Address - Fax:
Practice Address - Street 1:2237 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-3728
Practice Address - Country:US
Practice Address - Phone:626-429-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty