Rebecca Carrillo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A115409 Issued in CA

Practice address

704 Mountain Ranch Rd Ste 103
San Andreas, CA 95249-8903

Phone

(209) 754-6525

NPI assigned

Mar 26, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Southern California Keck School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• City of Berkeley

  • Adult Mental Health Clinic/Center
  • Berkeley, CA
  • NPI 1689799520

  CA

  Medicare reassignment NPD
• County of Calaveras

  • Community/Behavioral Health Agency
  • San Andreas, CA
  • NPI 1811945132

  CA

  Medicare reassignment NPD
• City of Berkeley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1710429642
  NPD
• City of Berkeley

  • Adolescent and Children Mental Health Clinic/Center
  • Berkeley, CA
  • NPI 1750415113
  NPD
• City of Berkeley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1215963699
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1003088428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043238",
            "telephone_number": "510-981-5290",
            "fax_number": "510-981-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 MOUNTAIN RANCH RD STE 103",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952498903",
            "telephone_number": "209-754-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "REBECCA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A115409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calaveras Emergency Physicians,
• Calaveras Sleep Diagnostics, LLC
• Calaveras Unified School District
• Leslie Calestini
• California Em-I Medical Services, a Medical Corporation
• Rea Carroll
• Tiara Carter
• Wendy J Carvajal, DDS
• Adrianna C Castle
• Center for Life Skills Coaching

• All providers in San Andreas, CA
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.