Anna Carrillo, M.D., a Medical Corporation

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ANNA CARRILLO, M.D., A MEDICAL CORPORATION

Practice address

11665 Avena PL Ste 204
San Diego, CA 92128-2428

Phone

(858) 848-4028

Fax

(858) 381-9769

NPI assigned

Jul 14, 2006

Organization subpart

No

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

Authorized official

Name

Anna Carrillo, M.D.

Title

President

Phone

(858) 848-4028

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1225054927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500226",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921500226",
            "telephone_number": "858-848-4028",
            "fax_number": "858-381-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 AVENA PL STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282428",
            "telephone_number": "858-848-4028",
            "fax_number": "858-381-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA CARRILLO, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-848-4028",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CA",
            "license": "A62084",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A62084",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.