CORY CARRILLO, BCBA — NPI 1699281675 (Licensed & Credentialed Behavior Analyst in VENTURA, CA)

CMS-1500 Box 24J / 33a • NPI

1699281675

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103K00000X

Licensed & Credentialed Behavior Analyst

Box 32 Service Location & ZIP+4

2421 PORTOLA RD, VENTURA, CA, 93003-8046

✓ 9-Digit EDI 837 ZIP+4 (93003-8046)

Practice Phone & Referral Fax

(805) 339-2654

Fax: (858) 649-6012

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1699281675 (CORY CARRILLO, BCBA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1699281675` (NPI-1 Individual Practitioner)
Provider / Legal Name	CORY CARRILLO, BCBA
Plain-English Specialty	Licensed & Credentialed Behavior Analyst NUCC Code: `103K00000X` (Behavior Analyst)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2421 PORTOLA RD, VENTURA, CA, 93003-8046
Practice Telephone / Fax	Tel: (805) 339-2654 \| Fax: (858) 649-6012
Administrative Mailing Address	224 COOK DR, FILLMORE, CA, 93015-1522
Enumeration & Last Sync	Enumerated: 2017-12-28 \| CMS Record Updated: 2022-12-13

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2421 PORTOLA RD, VENTURA, CA, 93003-8046

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Plain-English Taxonomy & CMS Crosswalk (103K00000X)

What Does Taxonomy Code 103K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103K00000X translates to:
"Licensed & Credentialed Behavior Analyst"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Behavior Analyst for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CORY CARRILLO, BCBA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`106S00000X` — Behavior Technician Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Technician	State: N/A \| License: `Verified` \| Primary: Secondary
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: CA \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CORY CARRILLO, BCBA (NPI #1699281675)