DR. KARIN CECILIA ULLTJAERN DNP, RN, PMHNP-BC
NPI 1104467190
Nurse Practitioner - Psychiatric/Mental Health in San Bernardino, CA
About Dr. Karin Cecilia Ulltjaern Dnp, Rn, Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KARIN CECILIA ULLTJAERN DNP, RN, PMHNP-BC (NPI 1104467190) is an individual psychiatric/mental health provider in San Bernardino, California, licensed in California (95012710) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Karin Cecilia Ulltjaern Dnp, Rn, Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Karin Cecilia Ulltjaern reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Highland, CA 92346
- Reassigned Medicare billing, California enrollment
- 2,584 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92410 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN BERNARDINO, CA 92410
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Karin Cecilia Ulltjaern's NPI number?
The NPI number for Karin Cecilia Ulltjaern is 1104467190. It was assigned to this individual provider in the NPPES registry on October 1, 2019.
Where is Karin Cecilia Ulltjaern located?
Karin Cecilia Ulltjaern practices at 250 S G St, San Bernardino, CA 92410. The listed phone number is (909) 382-7100.
What is Karin Cecilia Ulltjaern's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Karin Cecilia Ulltjaern enrolled in Medicare?
Yes. Karin Cecilia Ulltjaern is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Karin Cecilia Ulltjaern's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Karin Cecilia Ulltjaern reassigns Medicare benefits to Faculty Physicians And Surgeons Of Llusm (Highland, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Karin Cecilia Ulltjaern's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Karin Cecilia Ulltjaern was last updated on October 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Karin Cecilia Ulltjaern, DNP, RN, PMHNP-BC · NPI 1104467190
Psychiatric/Mental Health physician in San Bernardino, California. Individual provider, active in the CMS NPPES registry since October 1, 2019.
## Identity
- **NPI:** 1104467190 (Entity type: Individual)
- **Enumerated:** October 1, 2019
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 95012710 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 250 S G ST, San Bernardino, CA 92410-3320
- **Phone:** (909) 382-7100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Faculty Physicians And Surgeons Of Llusm (NPI 1689624991, Highland, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1104467190) · Data from the CMS NPPES public registry.