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Lisette Carrillo
Specialist in Oakland, California
NPI 1376143040

Lisette Carrillo is a Specialist based in Oakland, CA. Lisette Carrillo practices in Oakland, CA. The NPI Number for Lisette Carrillo is 1376143040 and holds a License No. (California).

The current practice location address for Lisette Carrillo is 6333 Telegraph Ave, Oakland, CA and can be reached out via phone at 510-923-1099 and via fax at 510-923-0894.

Location: 6333 Telegraph Ave, Oakland, CA, 94609-1359
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376143040
Provider Name
Lisette Carrillo
Credential
Provider Entity Type
Individual
Gender
Female
Address
6333 Telegraph Ave, Oakland, CA, 94609-1359
Phone Number
510-923-1099
Fax Number
510-923-0894
Provider Enumeration Date
10/30/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000111 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
6333 Telegraph Ave
City
Oakland
State
California
Zip
94609-1359
Phone Number
510-923-1099
Fax Number
510-923-0894
person
Provider Business Mailing Address Details
Address
6333 Telegraph Ave
City
Oakland
State
California
Zip
94609-1359
Phone Number
510-923-1099
Fax Number
510-923-0894
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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