Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARICRUZ PAT CARRILLO
NPI 1790289080
Psychologist - Clinical in San Diego, CA

Q: What is Maricruz Pat Carrillo's NPI number?

The NPI number for Maricruz Pat Carrillo is 1790289080. It was assigned to this individual provider in the NPPES registry on March 21, 2018.

Q: What is Maricruz Pat Carrillo's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since March 21, 2018

446 ALTA RD STE 6100, SAN DIEGO, CA 92158(619) 671-4400 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 5, 2026, May 17, 2021, Mar 21, 2018 (3 updates tracked since 2018).

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About Maricruz Pat Carrillo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARICRUZ PAT CARRILLO (NPI 1790289080) is an individual clinical provider in San Diego, California, licensed in California (PSB94026737) and active in the NPI registry since March 2018. She maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1790289080

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameMARICRUZ PAT CARRILLO

Location Address446 ALTA RD STE 6100San Diego, CA 92158-0001

Mailing Address734 10th AveSan Diego, CA 92101-6502

Phone(619) 671-4400

Sole ProprietorNo

Enumeration DateMarch 21, 2018

Last NPPES UpdateAugust 5, 20263 updates tracked since enumeration

NPPES CertifiedAugust 5, 2026

✔ NPI 1790289080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSB94026737

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

446 ALTA RD STE 6100, San Diego, CA 92158

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Secondary Practice Location 1

Location 1498 Perimeter RdSan Diego, CA 92158-0001 · Phone (619) 661-6500

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHAZ PAUL SIANGCO

Counselor