Individual provider · Type 1 NPI

Jessica Keakealani Carrillo, DPM

Foot & Ankle Surgery Podiatrist · Philadelphia, PA

NPI number 1508684697 Active

Practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Call (800) 836-7536 Map

Mailing address

1532 Rancho Ln
Norco, CA 92860-2325

Other practice locations

  • 148 N 8th St, Philadelphia, PA 19107-2418 · (949) 606-4057

Specialties and licenses

TaxonomyCodeLicense
Primary Podiatric Medicine Podiatrist 213EP1101XSC007586 (PA)
Foot & Ankle Surgery Podiatrist Primary 213ES0103XSC007586 (PA)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1508684697

Jessica Keakealani Carrillo, DPM's National Provider Identifier is 1508684697, issued on Sep 28, 2024. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 23, 2025.