Brandy R Carrillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53300 Issued in CA

Practice address

135 Carmen LN
Santa Maria, CA 93458-7729

Phone

(805) 332-4568

NPI assigned

Aug 23, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• County of Lake

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clearlake, CA
  • NPI 1326252271
  NPD (past)

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1760937338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 JEFFERSON LN APT 215",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956084968",
            "telephone_number": "559-790-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 CARMEN LN",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587729",
            "telephone_number": "805-332-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "BRANDY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Armando Carranza-Hernandez
• Britney Marie Carranza
• Javier Carranza, M.A.
• Christina Antonette Carrari, D.C.
• Chanel Carreira
• Jose Daniel Carrillo
• David Carroll, LCSW
• David Orry Carroll, QMHW
• Sara Carroll
• Bruce Tolbert Carter, DDS

• Physician Assistant in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.