Nancy Eimy Carrillo

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

22220694 Issued in CA

Practice address

5075 Shoreham PL Ste 115
San Diego, CA 92122-5927

Phone

(858) 272-2662

Fax

(858) 272-2661

NPI assigned

Jul 14, 2022

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

Electronic endpoints 1

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1558095596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 WHITAKER AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116708",
            "telephone_number": "619-721-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 SHOREHAM PL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225927",
            "telephone_number": "858-272-2662",
            "fax_number": "858-272-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "NANCY",
        "middle_name": "EIMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "22220694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "gveracruz@ascaba.com",
            "affiliation": "N",
            "endpointDescription": "Office Manager Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5075 Shoreham Pl Ste 115",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921225927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karla Carrillo
• Kathleen Carrillo
• Krystal Isabel Carrillo
• Lauren Carrillo
• Liliana Julisa Carrillo
• Nia Nicole Carrillo, MS, RYT, RMT
• Nicolas Shigeaki Carrillo
• Norma Carrillo
• Vanessa Marie Carrillo
• Ashley Carrington

• Behavior Technician in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.