Marta Patricia Carrillo, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86345152

Practice address

1524 Cordelia St
Chula Vista, CA 91913-1466

Phone

(619) 862-8480

NPI assigned

Jan 15, 2024

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

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Imperial Manor Skilled Nursing Inc

  • Rural Health Clinic/Center
  • Brawley, CA
  • NPI 1912662883
  Medicare reassignment NPD
• Legacy MD Medical Group Inc

  • General Practice Physician
  • El Centro, CA
  • NPI 1073210753
  Medicare reassignment NPD
• Easyaccess Medical Group, Inc

  • Urgent Care Clinic/Center
  • Calexico, CA
  • NPI 1386160810
  NPD (past)
• Legacy MD Medical Group Inc

  • Cardiac Rehabilitation Registered Nurse
  • Calexico, CA
  • NPI 1285494351
  NPD (past)

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1770354102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 CORDELIA ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131466",
            "telephone_number": "619-862-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 CORDELIA ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131466",
            "telephone_number": "619-862-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "MARTA",
        "middle_name": "PATRICIA",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86345152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betzy B Carrera
• Aaron Carrillo, LCSW
• Ashley Mireya Carrillo
• Cynthia Rene Carrillo
• Jessika Carrillo
• Melissa Carrillo
• Victor Hugo Carrillo, DDS
• Jillian Carroll
• Krizia Carroll
• Aliyah Carson, DO

• Registered Dietitian in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.