Javier Carrillo, PHD. PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JAVIER CARRILLO, PHD. PLLC

Practice address

2300 George Dieter Dr
El Paso, TX 79936-3963

Phone

(915) 491-0707

NPI assigned

Aug 11, 2020

Organization subpart

No

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

Authorized official

Name

Javier Carrillo, PHD

Title

Owner/Provider

Phone

(915) 491-0707

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1407467780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GEORGE DIETER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363963",
            "telephone_number": "915-491-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GEORGE DIETER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363963",
            "telephone_number": "915-491-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVIER CARRILLO, PHD. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "915-491-0707",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "24690",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in El Paso, TX
• Providers in El Paso, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.