Individual provider · Type 1 NPI

Oscar Omar Carrillo Miranda

Addiction (Substance Use Disorder) Counselor · Mammoth Lakes, CA

NPI number 1639096837 Active

Practice location

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601

Call (760) 924-1740 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1639096837

Oscar Omar Carrillo Miranda's National Provider Identifier is 1639096837, issued on Jun 30, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Mammoth Lakes, CA. The record was last updated on Jun 30, 2026.