Provider Demographics
NPI:1396402947
Name:CARRILLO, FRANCES ALEXANDRA
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:ALEXANDRA
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 S WESTERN AVE STE 542
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-4536
Mailing Address - Country:US
Mailing Address - Phone:405-508-1820
Mailing Address - Fax:
Practice Address - Street 1:5350 S WESTERN AVE STE 542
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4536
Practice Address - Country:US
Practice Address - Phone:405-508-1820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator