Individual provider Active NPI

Nancy Carrillo Rosas

  • Behavior Technician
  • Mammoth Lakes, CA
National Provider Identifier
1346830338
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1290 Tavern Road
Mammoth Lakes, CA 93546-2619
Phone
(769) 924-1740
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1290 Tavern Road
Mammoth Lakes, CA 93546-2619

Mailing address

1290 Tavern Road
Mammoth Lakes, CA 93546-2619
Phone (760) 924-1740

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mono County Behavioral Health CurrentSince Aug 28, 2022 Accepting new patients
County of Mono CurrentSince Jun 21, 2022 Accepting new patients

Locations

1290 Tavern Rd
Mammoth Lakes, CA 93546
Phone (760) 924-1740

Organizations & group practices 2

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1346830338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 TAVERN ROAD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462619",
            "telephone_number": "760-924-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN ROAD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462619",
            "telephone_number": "769-924-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO ROSAS",
        "first_name": "NANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mammoth Lakes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.