KRYSTAL ISABEL CARRILLO (NPI# 1871906735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871906735 |
| Entity Type | Individual |
| Full Name | KRYSTAL ISABEL CARRILLO |
| Practice Address |
2130 National Ave San Diego CA 92113 |
| Mailing Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 6195152338 |
| Mailing Telephone | 6195152300 |
| Mailing Fax Number | 6199064564 |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2018-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
80068 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2535 Kettner Blvd, Suite 1a4, San Diego, CA 921011250 | 6196150701 | |
| 525 E Main St, El Cajon, CA 920204007 | 6195152498 |
| Street Address |
2130 NATIONAL AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164671749 | Family Health Centers of San Diego, Inc. | Clinic/Center | 2130 National Ave, San Diego, CA 92113-2209 | 2008-09-18 |
| 1689149163 | Bessy Ortiz | Counselor | 2130 National Ave, San Diego, CA 92113-2209 | 2018-10-10 |
| 1548759038 | Diane Breske | Social Worker | 2130 National Ave, San Diego, CA 92113-2209 | 2018-05-09 |
| 1033623293 | Vivian K Ash | Social Worker | 2130 National Ave, San Diego, CA 92113-2209 | 2017-11-27 |
| 1437678364 | Family Health Centers of San Diego, Inc. | Clinic/Center | 2130 National Ave, San Diego, CA 92113-2209 | 2017-09-12 |
| 1225437973 | Sarah Porras | Counselor | 2130 National Ave, San Diego, CA 92113-2209 | 2014-08-19 |
| 1952741506 | Rita Isabel Mckinney | Marriage & Family Therapist | 2130 National Ave, San Diego, CA 92113-2209 | 2013-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305986 | Cynthia Alba | Nutritionist | 1809 National Ave., San Diego, CA 92113 | 2017-06-08 |
| 1184153983 | Jessy Milligan | Counselor | 4125 Alpha Street, San Diego, CA 92113 | 2017-06-06 |
| 1730557406 | Deborah Mary Malloy | Counselor | Jary Barreto, 2865 Logan Avenue, San Diego, CA 92113 | 2015-09-10 |
| 1104220912 | Imhotep Mustaqeem | Counselor | 3336 Steel Street, San Diego, CA 92113 | 2014-10-22 |
| 1831507300 | Olga Vasileva | Student in an Organized Health Care Education/Training Program | 2865 Logan Avenue, San Diego, CA 92113 | 2014-07-29 |
| 1477961951 | Angelica Quezada | Counselor | 32510 Newton Avenue B103, San Diego, CA 92113 | 2014-07-28 |
| 1477986750 | Anita Pena | Licensed Vocational Nurse | 604 Olivewood Ter, San Diego, CA 92113 | 2013-08-09 |
| 1134459399 | Susana Cabada | Technician, Other | 4031 Marine View Ave., San Diego, CA 92113 | 2010-01-11 |
| 1669595609 | Maria Emilia Siller | Registered Nurse | 3177a Oceanview Blvd, San Diego, AL 92113 | 2007-04-06 |
| 1710009691 | Maria Engracia Siordia | Licensed Vocational Nurse | 3177a Ocean View Blvd, San Diego, CA 92113 | 2007-04-04 |
| Find all providers in zip 92113 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920536 | Gillian Boyd | Social Worker | 3147 Eel Alley Building 271, Room 106, San Diego, CA 92136-0001 | 2020-10-18 |
| 1194338087 | Courage Over Comfort Counseling Licensed Clinical Social Worker PC | Social Worker | 4283 El Cajon Blvd Ste 226, San Diego, CA 92105-1289 | 2020-08-28 |
| 1619580057 | Joseph Stephen Mcconico | Social Worker | 5274 Mount Alifan Dr, San Diego, CA 92111-2621 | 2020-08-25 |
| 1821600529 | David James Prince | Social Worker | 1498 13th Street Bldg 184, San Diego, CA 98132 | 2020-08-24 |
| 1407467392 | Tyler Drew Willis | Social Worker | 4665 Voltaire St, San Diego, CA 92107-1762 | 2020-08-13 |
| 1174132575 | Sarah Greenstein | Social Worker | 11860 Carmel Creek Rd, San Diego, CA 92130-2474 | 2020-07-31 |
| 1730798190 | Joelle G Johnson | Social Worker | 4904 Mansfield St, San Diego, CA 92116-1936 | 2020-07-30 |
| 1881203503 | Micheaela Whaley | Social Worker | 4417 30th St Ste 112, San Diego, CA 92116-4284 | 2020-07-28 |
| 1033737812 | Clara Loginov | Social Worker | 6727 Mohawk St, San Diego, CA 92115-1642 | 2020-07-08 |
| 1780208553 | Ai-nhat Ngo | Social Worker | 9360 Activity Rd Ste B, San Diego, CA 92126-4410 | 2020-06-07 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.