Jose A Carrillo, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60417256 Issued in WA

Practice address

8514 W Gage Blvd Ste G
Kennewick, WA 99336

Phone

(509) 440-3387

Fax

(509) 491-3031

NPI assigned

Feb 23, 2016

Sex

Male

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": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1578922274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8514 W GAGE BLVD STE G",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368108",
            "telephone_number": "509-440-3387",
            "fax_number": "509-491-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8514 W GAGE BLVD STE G",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-440-3387",
            "fax_number": "509-491-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60417256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine V Carpenter, PA-C
• Stephanie Carpenter
• Amaris R Carrillo
• Elida Carrillo
• Elyde Marit Carrillo, PTA
• Alma John Carter, O.D.
• Charles Carter, PT
• Travis S Carter, DPM
• Alice Marie Carvo, PHARMD
• Amber L Casey, COTA

• Addiction (Substance Use Disorder) Counselor in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.