Carmen Lily Carrouche, RN, CNS, PMH-NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

23466 Issued in CA

Practice address

16 Ritter St
San Rafael, CA 94901-3323

Phone

(415) 457-8182

Fax

(415) 457-3490

NPI assigned

Mar 19, 2009

Last updated

Nov 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1043451198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 RITTER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013323",
            "telephone_number": "415-457-8182",
            "fax_number": "415-457-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 RITTER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013323",
            "telephone_number": "415-457-8182",
            "fax_number": "415-457-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROUCHE",
        "first_name": "CARMEN",
        "middle_name": "LILY",
        "credential": "RN, CNS, PMH-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "23466",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "510142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Sybeth Carrasquillo Sanchez
• Jennifer Carri
• Carlos Carrillo
• Julianne M Carroll, MA
• Kimberly Carroll
• Steven Cartacki, L.AC
• Estol Taylor Carte Jr., MD
• Amie Carter
• Jennifer Joy Carter
• Joseph John Carter, L. AC.

• Psychiatric/Mental Health Nurse Practitioner in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.