Jennifer Jazmin Carrillo

Individual provider Active NPI Behavior Analyst · McClellan, CA

NPI 1265150486 · NPPES record last updated Jun 1, 2026

Key facts

NPI
1265150486
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
5115 Dudley Blvd
McClellan, CA 95652-1024
Phone
(916) 566-1600
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

5115 Dudley Blvd
McClellan, CA 95652-1024

Mailing address

3186 Airway Ave Ste a
Costa Mesa, CA 92626-4650
Phone (714) 881-0427

Other providers in McClellan, CA

All providers in McClellan, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.