Jose Ayala-Carrillo, NP
Individual provider Active NPI Nurse Practitioner · Sausalito, CA
NPI 1124876792 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1124876792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 95023218 (CA)
- Practice address
- 1 Harbor Dr Ste 300
Sausalito, CA 94965-1434 - Phone
- (925) 550-4459
- NPI assigned
- May 9, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95023218 | CA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95023218 | CA | Yes |
Addresses
Primary practice location
1 Harbor Dr Ste 300
Sausalito, CA 94965-1434
Mailing address
2005 Davidson PL
Whiting, IN 46394-2026
Phone (312) 607-8505
Other practice location 1
1417 W Beverly Blvd Ste 106
Montebello, CA 90640-4125
Phone (310) 242-0919
Other providers in Sausalito, CA
- Emilia Ebere Anyah
- Debra Jean Araujo
- Aromance Life Institute of Holistic & Comprehensive Health&Nursing Inc
- Aromance Life Institute of Holistic and Comprehensive LLC
- Melanie Nejame Ash
- Carol Shira Barnett I
- Rick Allen Bauer
- Deborah Paola Baumgarten
- Bay Area Pain Medical Associates
- Sheri Noelle Beasley
All providers in Sausalito, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.