Active NPI
Kyrene Alexandra Carrillo, BT
- Behavior Technician
- Fremont, CA
National Provider Identifier
1518831445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 39201 State St.
Fremont, CA 94538 - Phone
- (510) 347-8105
- NPI assigned
- Oct 2, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CA | Primary |
Addresses
Primary practice location
39201 State St.
Fremont, CA 94538
Mailing address
1734 Bobolink CT
Hayward, CA 94545
Phone (510) 999-0926
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
- Credentials
- Bachelor of Theology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1518831445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1734 BOBOLINK CT",
"city": "HAYWARD",
"state": "CA",
"postal_code": "94545",
"telephone_number": "510-999-0926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39201 STATE ST.",
"city": "FREMONT",
"state": "CA",
"postal_code": "94538",
"telephone_number": "510-347-8105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "KYRENE",
"middle_name": "ALEXANDRA",
"credential": "BT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-02",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.