Active NPI
Alvaro Carrillo
- Assistant Behavior Analyst
- Las Vegas, NV
National Provider Identifier
1417408675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- Practice address
- 5409 Goldbrush St
Las Vegas, NV 89130-1678 - Phone
- (702) 287-9127
- Fax
- (702) 570-5200
- NPI assigned
- Oct 21, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5409 Goldbrush St
Las Vegas, NV 89130-1678
Mailing address
5409 Goldbrush St
Las Vegas, NV 89130-1678
Phone (702) 287-9127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1604211634 | Other | NV | MEDICAID |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1417408675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5409 GOLDBRUSH ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891301678",
"telephone_number": "702-287-9127",
"fax_number": "702-570-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5409 GOLDBRUSH ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891301678",
"telephone_number": "702-287-9127",
"fax_number": "702-570-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "ALVARO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "1604211634",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.