Kathleen Carrillo

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

53024 Issued in CA

Practice address

5030 Camino de la Siesta Ste 220
San Diego, CA 92108-3118

Phone

(619) 788-4660

Fax

(619) 260-0201

NPI assigned

Jun 26, 2026

Last updated

Jun 26, 2026By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Innovative Physical Therapy Inc

  • Orthopedic Physical Therapist
  • San Diego, CA
  • NPI 1821047580
  NPD (past)

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1154247732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083118",
            "telephone_number": "619-788-4660",
            "fax_number": "619-260-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083118",
            "telephone_number": "619-788-4660",
            "fax_number": "619-260-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "53024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estefany Carrillo
• Francesco Carrillo
• Jaimee Stephanie Carrillo, PHARM. D.
• Jamie Paulene Carrillo, RN
• Karla Carrillo
• Krystal Isabel Carrillo
• Lauren Carrillo
• Liliana Julisa Carrillo
• Nancy Eimy Carrillo
• Nia Nicole Carrillo, MS, RYT, RMT

• Physical Therapy Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.