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

Jacqueline Lizet Carrillo, AG-NP

Individual provider Primary Care Nurse Practitioner · NPI 1063178861

Jacqueline Lizet Carrillo, AG-NP is a Nurse Practitioner in San Francisco, California. Qualified in 2021, 5 years ago. Practices with Northbay Physicians Surgery Center, LLC, a 337-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

4150 Clement St
San Francisco, CA 94121-1563
Phone: (415) 750-2110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2145 University Ave, Berkeley, CA 94704-1025 — (888) 663-6331

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 95018581 (CA)

Record details

NPI number1063178861
Entity typeIndividual (Type 1)
GenderFemale
Credentials AG-NP
Sole proprietorNo
NPI enumeratedNovember 16, 2021
Last updated in NPPESJune 22, 2026
Certification dateJune 22, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northbay Physicians Surgery Center, Llc — 337 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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