ALEXIS LEIGH CARRILLO-HOLGUIN (NPI# 1184286304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184286304 |
| Entity Type | Individual |
| Full Name | ALEXIS LEIGH CARRILLO-HOLGUIN |
| Credential | RDHAP |
| Practice Address |
501 W Broadway Ste 800 San Diego CA 92101-3546 |
| Practice Telephone | 6193680053 |
| Mailing Telephone | 6193680053 |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125K00000X | Advanced Practice Dental Therapist | HAP741 | CA | Dental Providers |
| Street Address |
501 W BROADWAY STE 800 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92101-3546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487057451 | Jessica Nicolosi | Behavioral Analyst | 501 W Broadway Ste 800, San Diego, CA 92101 | 2014-10-03 |
| 1336749001 | Cali Ann Martinez | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-30 |
| 1518567536 | Georgia Autumn Dickerson | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-28 |
| 1477152429 | Rosa Maria Tascher | Technician, Other | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-21 |
| 1467051425 | Maria Dolores Estrada | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-21 |
| 1518565142 | Koosha Heidari | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-15 |
| 1295332070 | Jialin Liu | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-05 |
| 1861099764 | Daisy Marcial | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-10-04 |
| 1043827710 | Jennifer Villalobos | Behavioral Analyst | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-09-28 |
| 1629685375 | Elizabeth Chantell Allen | Behavior Technician | 501 W Broadway Ste 800, San Diego, CA 92101-3546 | 2020-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415472 | Ryanleo Flores | Nurse Practitioner | 2017 1st Avenue, Suite 301, San Diego, CA 92101 | 2020-10-18 |
| 1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
| 1235752585 | Liminal Solutions LLC | Home Health | 845 15th Street, Floors 1-4, San Diego, CA 92101 | 2020-05-21 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1700380086 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1850 5th Ave, San Diego, CA 92101 | 2018-03-21 |
| 1013436161 | Yasmin Galicianava | Student in an Organized Health Care Education/Training Program | 734 Tenth Ave, San Diego, CA 92101 | 2017-09-10 |
| 1487172516 | Jessica Roach | Counselor | 1045 9th Avenue, San Diego, CA 92101 | 2017-09-09 |
| 1699204099 | Lisa Nunez | Student in an Organized Health Care Education/Training Program | 1963 4th Avenue, San Diego, CA 92101 | 2017-06-08 |
| 1356882245 | Dajah Mone't Lockett | Counselor | 2535 Kettner Blvd Suite 1a4, San Diego, CA 92101 | 2017-03-13 |
| 1649718495 | Luigi Bunyi | Behavior Technician | 501 W Broadway Suite 800, San Diego, CA 92101 | 2017-02-01 |
| Find all providers in zip 92101 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750823514 | Joel Tzinberg | Advanced Practice Dental Therapist | 6280 Jackson Dr, Suite 5, San Diego, CA 92119-3434 | 2016-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760459 | Carlos Heriberto Quinonez | Advanced Practice Dental Therapist | 16077 Chella Dr, Hacienda Heights, CA 91745-6402 | 2020-11-06 |
| 1033753298 | Lynnette Bradley | Advanced Practice Dental Therapist | 4218 Giles Ct, Riverside, CA 92503-3154 | 2019-10-31 |
| 1598314023 | Peter Korn | Advanced Practice Dental Therapist | 11135 Rosemary Dr, Auburn, CA 95603-5945 | 2019-09-06 |
| 1154982395 | Evelyn Marie Schrager | Advanced Practice Dental Therapist | 803 E Woodhaven Ln, Fresno, CA 93720-1209 | 2019-06-27 |
| 1558828160 | Charon Moody | Advanced Practice Dental Therapist | 727 E Holborn Dr, Carson, CA 90746-2328 | 2019-03-01 |
| 1104371368 | Marie Ekins Rdhap Corp | Advanced Practice Dental Therapist | 10831 Canelo Rd, Whittier, CA 90604-1902 | 2016-08-17 |
| 1922484682 | Travis Tramel | Advanced Practice Dental Therapist | 4199 Flat Rock Dr, Suite 127, Riverside, CA 92505-7115 | 2015-08-05 |
| 1851774186 | Terri De La Pena | Advanced Practice Dental Therapist | 10011 Shaggybark Dr, Santee, CA 92071-1136 | 2015-07-06 |
| 1720470230 | Christine Jackson-bartolomei | Advanced Practice Dental Therapist | 4806 Darlington Ln, Sacramento, CA 95835-2000 | 2015-02-21 |
| 1356753826 | Megan Ellen Graff | Advanced Practice Dental Therapist | 6084 Gold Spirit St, Eastvale, CA 92880-0988 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ALEXIS LEIGH CARRILLO-HOLGUIN.
| 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.