Marie Claudia Carrillo-Bertolucci, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

51399 Issued in CA

Practice address

39270 Paseo Padre Pkwy # 207
Fremont, CA 94538-1616

Phone

(323) 819-5223

NPI assigned

Aug 20, 2021

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

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1174299986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 LAKE ST",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302926",
            "telephone_number": "323-819-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39270 PASEO PADRE PKWY # 207",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381616",
            "telephone_number": "323-819-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO-BERTOLUCCI",
        "first_name": "MARIE",
        "middle_name": "CLAUDIA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Carr
• Kathleen M Carr, LCSW
• Lance Thomas Carr, MA, PPS
• Abigail Rose Carreker
• Ella Carrell
• Kyrene Alexandra Carrillo, BT
• Maurice Carson
• Moneisa Carson
• Andrea Carter
• Stephanie Carter

• Physical Therapy Assistant in Fremont, CA
• Providers in Fremont, 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 8, 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.