Adrian Jacob Carrasco

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Practice address

1738 N Waterman Ave Ste 1
San Bernardino, CA 92404-5131

Phone

(909) 693-3302

NPI assigned

Jan 23, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1366940579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 SANTO ANTONIO DR STE B",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923248183",
            "telephone_number": "909-433-9824",
            "fax_number": "909-433-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 N WATERMAN AVE STE 1",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045131",
            "telephone_number": "909-693-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1076 Santo Antonio Dr",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923248103",
            "country_code": "US",
            "telephone_number": "909-433-9824",
            "fax_number": "909-433-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "ADRIAN",
        "middle_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "2110806-I",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bettye Shante' Carr
• Cecilia Rose Carr
• Kaylene R Carr, M.D.
• Christine Carranza
• Paulina Carranza
• Adrian Carreno
• Tyan Carrico
• Alejandro Elias Carrillo
• Celeny Carrillo
• Jessica Carrillo

• Day Training/Habilitation Specialist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Day Training/Habilitation Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.