Julissa Leonides Caraballo, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95005201 Issued in CA

Practice address

4044 Promontory St
San Diego, CA 92109-5334

Phone

(917) 757-2230

NPI assigned

Mar 7, 2020

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1730714007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 PROMONTORY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095334",
            "telephone_number": "917-757-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4044 PROMONTORY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095334",
            "telephone_number": "917-757-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "JULISSA",
        "middle_name": "LEONIDES",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95005201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Daniele Vanni Capucho
• Maureen Quiambao Capuno
• Devin Marie Caputo, RBT
• Donica Marie Carabajal
• Caitlin Caraballo
• Tanya Caraballo, LCSW
• Naji Caracalla, RPH
• Laurie Caracappa, LCSW
• Brooke Caragata
• Aeriel Caraglio, DPT

• Adult Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; 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.