Jaime Kamaile Carrillo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

689151 Issued in CA

Practice address

3160 E del Mar Blvd
Pasadena, CA 91107-4649

Phone

(626) 270-2400

Fax

(626) 270-2498

NPI assigned

Oct 23, 2013

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

Other names 1

• Jaime Kamaile Kobashigawa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1568890945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17321 BOSWELL PL",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913441023",
            "telephone_number": "808-387-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 E DEL MAR BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074649",
            "telephone_number": "626-270-2400",
            "fax_number": "626-270-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JAIME",
        "middle_name": "KAMAILE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "689151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "KOBASHIGAWA",
            "middle_name": "KAMAILE",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adriana G. Carrillo, LCSW
• Athena Carrillo
• Beatriz A Carrillo
• Cassandra Meza Carrillo, LCSW
• Elvis Carrillo
• Jasmin Araceli Carrillo
• Julian J. Carrillo, B.A.
• Vanessa Carrillo, LMFT
• Victoria Carmen Carrillo, ASW
• Matthew James Carroll

• Family Nurse Practitioner in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.