Alexandra Grace Carrillo, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120820 Issued in CA

Practice address

2629 Clarendon Ave FL 2N
Huntington Park, CA 90255-4119

Phone

(909) 762-5662

NPI assigned

Nov 19, 2018

Last updated

Jul 19, 2024By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1447729421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 CLARENDON AVE FL 2",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554119",
            "telephone_number": "909-762-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 CLARENDON AVE FL 2N",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554119",
            "telephone_number": "909-762-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "ALEXANDRA",
        "middle_name": "GRACE",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "120820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Dental Group of Robert a Bobic
• Caremont Hospice, Inc.
• Sean Tonley Carlson
• Sandra Carrasquillo
• Victoria Carretero
• Bernardo Jose Carrillo, P.A.
• Daniel Carrillo, PHARMD.
• Ernestina Carrillo
• Lesley Vanessa Carrillo, DMD
• Antwon Carter

• Clinical Social Worker in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.