Jacqueline Lizet Carrillo
Nurse Practitioner - Primary Care
2425 Humphrey Ave
Richmond
, California 94804-1232
Jacqueline Lizet Carrillo
Nurse Practitioner - Primary Care
2425 Humphrey Ave
Richmond
, California 94804-1232
(650) 759-8377
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Jacqueline Lizet Carrillo
- 2425 Humphrey Ave
- Richmond, CA
- Zip : 94804-1232
- Phone : (650) 759-8377
Second Address
- Jacqueline Lizet Carrillo
- 2425 Humphrey Ave
- Richmond, CA
- Zip : 94804-1232
- Phone : (650) 759-8377
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | 95018581 | CA |
National Provider Identifier
| NPI | 1063178861 |
|---|---|
| Provider Name | Jacqueline Lizet Carrillo |
| First Address | Richmond, CA 94804-1232 |
| Second Address | Richmond, CA 94804-1232 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/11/2021 |
| Last Update Date | 16/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.