Individual provider Active NPI

Abel A. Carrillo

  • Counselor
  • Costa Mesa, CA
National Provider Identifier
1245505502
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3188 Airway Ave Ste F
Costa Mesa, CA 92626-4652
Phone
(714) 689-1380
Fax
(714) 689-1381
NPI assigned
Mar 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

3188 Airway Ave Ste F
Costa Mesa, CA 92626-4652

Mailing address

3188 Airway Ave Ste F
Costa Mesa, CA 92626-4652
Phone (714) 689-1380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1245505502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3188 AIRWAY AVE STE F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264652",
            "telephone_number": "714-689-1380",
            "fax_number": "714-689-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 AIRWAY AVE STE F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264652",
            "telephone_number": "714-689-1380",
            "fax_number": "714-689-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "ABEL",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.