Provider Demographics
NPI:1538953427
Name:INES, HECTOR ALBERT CARILLO
Entity type:Individual
Prefix:
First Name:HECTOR ALBERT
Middle Name:CARILLO
Last Name:INES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 ARNOLD DR STE 142
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-6538
Mailing Address - Country:US
Mailing Address - Phone:925-435-6545
Mailing Address - Fax:
Practice Address - Street 1:1330 ARNOLD DR STE 142
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6538
Practice Address - Country:US
Practice Address - Phone:925-435-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator