ELICIA AZALIA CARRILLO (NPI# 1730792532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730792532 |
| Entity Type | Individual |
| Full Name | ELICIA AZALIA CARRILLO |
| Practice Address |
2440 Tulare St Ste 200 Fresno CA 93721-2281 |
| Practice Telephone | 5594434800 |
| Mailing Telephone | 5594434800 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2440 TULARE ST STE 200 |
| City | FRESNO |
| State | CA |
| Zip Code | 93721-2281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184735581 | Yovana Y Munro | Marriage & Family Therapist | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2006-08-31 |
| 1043823248 | Clarissa Gomez Olivas | Student in an Organized Health Care Education/Training Program | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-08-26 |
| 1659984383 | Ellen Kyurinyan | Student in an Organized Health Care Education/Training Program | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-08-24 |
| 1881202422 | Lana Mak-phanitsiri | Counselor | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-20 |
| 1083222624 | Rebecca Ruth Ann Brisky | Marriage & Family Therapist | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-20 |
| 1689292484 | Michelle C Faulkner | Marriage & Family Therapist | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-08 |
| 1679191472 | Michelle Marin | Counselor | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-08 |
| 1033737846 | Kristen Madson | Marriage & Family Therapist | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-08 |
| 1851919666 | Yolanda Castaneda | Counselor | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-08 |
| 1174141055 | Andrew M Marquez | Social Worker | 2440 Tulare St Ste 200, Fresno, CA 93721-2281 | 2020-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1619521929 | Kepler Education Incorporation | Local Education Agency (LEA) | 1462 Broadway St., Fresno, CA 93721 | 2019-07-25 |
| 1588156434 | Micha Ramirez | Case Manager/Care Coordinator | 2140 Merced St., Fresno, CA 93721 | 2018-06-05 |
| 1649798992 | Nadia C Martinez | Licensed Vocational Nurse | 1310 M. Street, Fresno, CA 93721 | 2017-09-07 |
| 1538604251 | Be Together Home Care LLC | In Home Supportive Care | 2014 Tulare St Ste 605, Fresno, CA 93721 | 2017-01-04 |
| 1124426705 | Central California Faculty Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2554 Merced Street, Fresno, CA 93721 | 2014-12-12 |
| 1427455336 | University Medical Supply | Durable Medical Equipment & Medical Supplies | 2554 Merced St, Fresno, CA 93721 | 2014-11-21 |
| 1154723542 | Ryan Gil | Physical Therapist | 1350 O St Ste 201, Fresno, CA 93721 | 2014-09-17 |
| 1831526250 | Tiffany Marie Gonzalez | Counselor | 2409 Mered St #106, Fresno, CA 93721 | 2013-09-30 |
| 1972939783 | Reshale L Thomas | Psychologist | 2900 Fresno St Ste 108, Fresno, CA 93721 | 2013-09-25 |
| Find all providers in zip 93721 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526672 | Chandni T Patel | Student in an Organized Health Care Education/Training Program | 9715 N Willey Ct, Fresno, CA 93720-5418 | 2020-07-29 |
| 1649892514 | Jasdeep Brar | Student in an Organized Health Care Education/Training Program | 4409 E Inyo St. Unit A, Fresno, CA 93702-2977 | 2020-05-13 |
| 1396364048 | Dessere Givertz | Student in an Organized Health Care Education/Training Program | 10155 N Edgewood Dr, Fresno, CA 93720-3423 | 2020-04-13 |
| 1366061129 | Ariel Lok Yen Leung | Student in an Organized Health Care Education/Training Program | 1313 East Herndon Ave, St 105, Fresno, CA 93720 | 2020-04-13 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1669001632 | Hunza Chaudhry | Student in an Organized Health Care Education/Training Program | 155 N Fresno St Ste 307, Fresno, CA 93701-2302 | 2020-04-02 |
| 1720616345 | Veronica Moffitt | Student in an Organized Health Care Education/Training Program | 6536 N Wheeler Ave, Fresno, CA 93722-3007 | 2020-03-30 |
| 1225682701 | Mariah Isabel Negrete | Student in an Organized Health Care Education/Training Program | 5503 W Pinedale Ave, Fresno, CA 93722-2348 | 2019-08-01 |
| 1174184543 | Keschia Matthews | Student in an Organized Health Care Education/Training Program | 2118 Beacon Light Ln, Fresno, TX 77545-7089 | 2019-06-25 |
| 1710545884 | Tanica Eboni Washington | Student in an Organized Health Care Education/Training Program | 4151 N Blythe Ave Apt 132, Fresno, CA 93722-6376 | 2019-06-03 |
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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.