Krystal Isabel Carrillo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80068 Issued in CA

Practice address

2130 National Ave
San Diego, CA 92113

Phone

(619) 515-2338

NPI assigned

Jun 9, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1871906735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92113",
            "telephone_number": "619-515-2338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2535 Kettner Blvd",
            "address_2": "Suite 1A4",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921011250",
            "country_code": "US",
            "telephone_number": "619-615-0701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 E Main St",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920204007",
            "country_code": "US",
            "telephone_number": "619-515-2498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "KRYSTAL",
        "middle_name": "ISABEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francesco Carrillo
• Jaimee Stephanie Carrillo, PHARM. D.
• Jamie Paulene Carrillo, RN
• Karla Carrillo
• Kathleen Carrillo
• Lauren Carrillo
• Liliana Julisa Carrillo
• Nancy Eimy Carrillo
• Nia Nicole Carrillo, MS, RYT, RMT
• Nicolas Shigeaki Carrillo

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.