MRS. GINA MICHELLE CARRILLO-JACKMAN LCSW
NPI 1053018911
Social Worker - Clinical in Oak Park, CA

Active since February 10, 2023
6193 BARONS WAY, OAK PARK, CA 91377(818) 584-6395 Get Directions Write a Review

NPPES record last updated: February 10, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Gina Michelle Carrillo-jackman Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. GINA MICHELLE CARRILLO-JACKMAN LCSW (NPI 1053018911) is an individual clinical provider in Oak Park, California, licensed in California (21810) and active in the NPI registry since February 2023.

NPPES Registry Identity

NPI1053018911
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. GINA MICHELLE CARRILLO-JACKMANCredential: LCSW
Location Address6193 BARONS WAYOak Park, CA 91377-5849
Mailing Address5737 Kanan Rd # 438Agoura, CA 91301-1601 · (818) 854-0081
Sole ProprietorYes
Enumeration DateFebruary 10, 2023
NPPES CertifiedFebruary 10, 2023
NPI 1053018911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in CA · 21810
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

6193 BARONS WAY, Oak Park, CA 91377

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gina Carrillo-jackman's NPI number?

The NPI number for Gina Carrillo-jackman is 1053018911. It was assigned to this individual provider in the NPPES registry on February 10, 2023.

Where is Gina Carrillo-jackman located?

Gina Carrillo-jackman practices at 6193 Barons Way, Oak Park, CA 91377. The listed phone number is (818) 584-6395.

What is Gina Carrillo-jackman's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Gina Carrillo-jackman was last updated on February 10, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.