Eduardo Guadalupe Carrizosa

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1100 N D St
San Bernardino, CA 92410-3524

Phone

(909) 884-0840

NPI assigned

Nov 27, 2023

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

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1831965243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103524",
            "telephone_number": "909-884-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103524",
            "telephone_number": "909-884-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIZOSA",
        "first_name": "EDUARDO",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Carrillo
• Katherine Bronner Carrillo
• Melissa Carrillo
• Veronica Carrillo
• Tere-Monique Oresa Carrington, DNP, APRN, FNP-C
• Robert Duncan Carruthers
• Mabel E Carson, FNP-C
• Carter Lane, D.D.S., M.S.
• Brittany Carter
• Bryan Carter

• Addiction (Substance Use Disorder) Counselor in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.