Maya Devonne Carroll, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95013568 Issued in CA

Practice address

150 Valpreda Rd
San Marcos, CA 92069-2973

Phone

(760) 736-6780

NPI assigned

Jan 9, 2020

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mcarroll764613@direct.ochin.org
• Direct secure messaging: mcarroll1219056@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1245246917
  Medicare reassignment NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • Oceanside, CA
  • NPI 1245770825
  NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • Encinitas, CA
  • NPI 1447267349
  NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1588489975
  NPD

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1699315473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34640 MEADOWSIDE LN",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925965212",
            "telephone_number": "931-217-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MAYA",
        "middle_name": "DEVONNE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95013568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jozette Carrico
• Janet Carrillo-Camacho, RN, PHN
• Rubee Carrillo
• John August Carrion, P.T.
• Joseph Brian Carroll, FNP
• Lexxus Carter
• Casa de Amparo
• Casa de Amparo
• Casa de Amparo
• Casa de Amparo

• Psychiatric/Mental Health Nurse Practitioner in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.