Active NPI
Jackelyn Cecilia Carrillo, RBT
- Behavior Analyst
- Carlsbad, CA
National Provider Identifier
1912654450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-21-156952
- Practice address
- 5870 El Camino Real Ste 101
Carlsbad, CA 92008-8816 - Phone
- (760) 539-5818
- NPI assigned
- Mar 4, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT-21-156952 | CA | Primary |
Addresses
Primary practice location
5870 El Camino Real Ste 101
Carlsbad, CA 92008-8816
Mailing address
3389 Tonopah St
Oceanside, CA 92054-3865
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-156952 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646352000000",
"number": "1912654450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3389 TONOPAH ST",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920543865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5870 EL CAMINO REAL STE 101",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920088816",
"telephone_number": "760-539-5818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "JACKELYN",
"middle_name": "CECILIA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-04",
"last_updated": "2022-03-04",
"certification_date": "2022-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "RBT-21-156952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.