Active NPI
Miriam Carrillo
- Rehabilitation Practitioner
- Oxnard, CA
National Provider Identifier
1558094524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1911 Williams Dr # 165
Oxnard, CA 93036-2612 - Phone
- (805) 981-4323
- NPI assigned
- Jul 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1911 Williams Dr # 165
Oxnard, CA 93036-2612
Mailing address
1911 Williams Dr # 165
Oxnard, CA 93036-2612
Phone (805) 981-4233
Other practice location 1
1700 Rubio Cir
Oxnard, CA 93030-0104
Phone (805) 889-0963
Other practice location 2
5284 Adolfo Rd
Camarillo, CA 93012-6787
Phone (805) 289-0120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56CC | Other | CA | MEDICAL |
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": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1558094524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 WILLIAMS DR # 165",
"city": "OXNARD",
"state": "CA",
"postal_code": "930362612",
"telephone_number": "805-981-4233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1911 WILLIAMS DR # 165",
"city": "OXNARD",
"state": "CA",
"postal_code": "930362612",
"telephone_number": "805-981-4323"
}
],
"practiceLocations": [
{
"address_1": "1700 Rubio Cir",
"address_purpose": "LOCATION",
"city": "Oxnard",
"state": "CA",
"postal_code": "930300104",
"country_code": "US",
"telephone_number": "805-889-0963",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5284 Adolfo Rd",
"address_purpose": "LOCATION",
"city": "Camarillo",
"state": "CA",
"postal_code": "930126787",
"country_code": "US",
"telephone_number": "805-289-0120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARRILLO",
"first_name": "MIRIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-06",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "56CC",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxnard, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.