Carrillo-Jackman, Gina Michelle

Carrillo-Jackman, Gina Michelle is an sole proprietor health care provider with primary practice located at 6193 Barons Way , Oak Park CA 91377-5849. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Carrillo-Jackman, Gina Michelle can be contacted via phone (818) 584-6395.

Contact Information

Primary practice address
6193 Barons Way Oak Park CA 91377-5849
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 21810 California

Profile Details

NPI number 1053018911
LBN Legal business name Carrillo-Jackman, Gina Michelle
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 10th, 2023
Last updated Feb 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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