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DOREEN KELLIE CARRILLO FNP
NPI 1851948046
Registered Nurse in Stockton, CA

Active since August 22, 2019PECOS Enrolled
582 E HARDING WAY, STOCKTON, CA 95204(888) 530-4415 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 26, 2026, Jul 22, 2026, Jun 11, 2021 and 1 more (4 updates tracked since 2019).

About Doreen Kellie Carrillo Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOREEN KELLIE CARRILLO FNP (NPI 1851948046) is an individual registered nurse in Stockton, California, licensed in California (95012375) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851948046
Entity TypeIndividualFemale
Primary Taxonomy163W00000X
Provider Legal NameDOREEN KELLIE CARRILLOCredential: FNP
Location Address582 E HARDING WAYStockton, CA 95204-6110
Mailing Address582 E Harding WayStockton, CA 95204-6110 · (209) 373-5445 · Fax (844) 226-9193
Phone(888) 530-4415
Sole ProprietorYes
Enumeration DateAugust 22, 2019
Last NPPES UpdateAugust 26, 20264 updates tracked since enumeration
NPPES CertifiedAugust 26, 2026
✔ NPI 1851948046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in CA · 95012375
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
582 E HARDING WAY, Stockton, CA 95204
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Doreen Kellie Carrillo Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Doreen Carrillo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Snf Wound Care
315 mi
Internal Medicine
11270 EXPOSITION BLVD FL 1, BOX: 641519
Los Angeles, CA 90064
  • Reassigned Medicare billing, California enrollment
  • 75 clinicians in this Medicare group
NPI 1114393311 (833) 379-6863

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JAGDISH SINGH NIJJAR FNP-C
Nurse Practitioner
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (844) 226-9193
DR. USMAN M ALI M.D.
Internal Medicine
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (888) 530-4415
MAYA JUSTINA-ELIA RAMIREZ MSW
Social Worker (Clinical)
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (209) 226-3325
ROSALIA RAVELO OTR
Occupational Therapist
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (888) 530-4415
MRS. JAMIE MARINA FLORES LCSW
Social Worker (Clinical)
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (209) 932-0357
ALYSSA ABREU PHD, RD
Dietitian, Registered
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (209) 326-0713
JOEL EIDELSON
General Practice
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (209) 819-7178
SAJJAD BIDAR
Physician Assistant
582 E HARDING WAY
STOCKTON, CA 95204
San Joaquin County (925) 325-2028

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 Doreen Carrillo's NPI number?

The NPI number for Doreen Carrillo is 1851948046. It was assigned to this individual provider in the NPPES registry on August 22, 2019.

Where is Doreen Carrillo located?

Doreen Carrillo practices at 582 E Harding Way, Stockton, CA 95204. The listed phone number is (888) 530-4415.

What is Doreen Carrillo's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Is Doreen Carrillo enrolled in Medicare?

Yes. Doreen Carrillo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Doreen Carrillo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Doreen Carrillo reassigns Medicare benefits to Snf Wound Care (Los Angeles, 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 Doreen Carrillo'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 Doreen Carrillo was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.