Provider Demographics
NPI:1871611020
Name:DI CARLO, JILL SHERIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:SHERIE
Last Name:DI CARLO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:SHERIE
Other - Last Name:PANATTONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:3450 PALMER DRIVE
Mailing Address - Street 2:SUITE 4148
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682
Mailing Address - Country:US
Mailing Address - Phone:530-210-6782
Mailing Address - Fax:916-923-0170
Practice Address - Street 1:3870 ROSIN COURT
Practice Address - Street 2:SUITE 130
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834
Practice Address - Country:US
Practice Address - Phone:530-210-6782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42656106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist