Individual provider Active NPI

Ana Valeria Carrillo San Juan

  • Marriage & Family Therapist
  • Santa Clara, CA
National Provider Identifier
1265225452
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
120695 Issued in CA
Practice address
1889 Lawrence Rd
Santa Clara, CA 95051-2166
Phone
(669) 369-4181
NPI assigned
May 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 120695 CA Primary

Addresses

Primary practice location

1889 Lawrence Rd
Santa Clara, CA 95051-2166

Mailing address

1889 Lawrence Rd
Santa Clara, CA 95051-2166

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

State licenses

LicenseStateTypeSpecialty
120695CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Clara Unified School District PastSince Jun 3, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1265225452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1889 LAWRENCE RD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950512166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 LAWRENCE RD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950512166",
            "telephone_number": "669-369-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO SAN JUAN",
        "first_name": "ANA",
        "middle_name": "VALERIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.