Vanessa Marie Carrillo
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1104797158
StatusActive
Last updated in NPPESSep 15, 2025
Details
- NPI
- 1104797158
- Entity type
- Individual (NPI-1)
- Name
- Vanessa Marie Carrillo
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 15, 2025
- Certification date
- Sep 14, 2025
- Last updated
- Sep 15, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | CA | Yes |
Practice location
3878 Ruffin Rd Ste BSan Diego, CA 92123-1842
Phone 619-795-9925
Mailing address
3326 Cowley Way Apt 2San Diego, CA 92117-6313
Phone 661-578-1658
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8,296 Behavior Technician providers in San Diego · All 61,118 providers in San Diego
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