Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian J Carrillo

Individual provider Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1245590678

Brian J Carrillo is an Emotionally Disturbed Childrens' Residential Treatment Facility in Gardena, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2012
Specialties on file
2

Practice location Address checks out

18726 S Western Ave Ste 408
Gardena, CA 90248-3858
Phone: (310) 856-0800
Fax: (855) 568-2494
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 714 W Main St, Grass Valley, CA 95945-6410 — (530) 477-9800

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X (CA)
Emotionally Disturbed Childrens' Residential Treatment Facility Taxonomy 322D00000X

Record details

NPI number1245590678
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 18, 2012
Last updated in NPPESMarch 17, 2018
Mailing address18726 S Western Ave Ste 408, Gardena, CA 90248-3858

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