Mary E Carroll-Ambrose, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

18355 Issued in CA

Practice address

3325 Chanate Rd
Santa Rosa, CA 95404-1707

Phone

(707) 576-4953

NPI assigned

Aug 28, 2008

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

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1336397744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 OAK PARK WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093732",
            "telephone_number": "707-576-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-576-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL-AMBROSE",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "18355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Carrillo Villegas
• Maleni Carrillo- Gomez
• Alyssa Nicole Carrillo, AU.D.
• Pablo Galvan Carrillo
• Roberto Gabriel Carrillo
• Dene Carroll, LCSW
• Emma Carroll, RN
• Mark Carroll, LAC
• Meaghan Carroll, RN
• William Carroll, LMFT

• Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.