Individual provider Active NPI

Carolina Osorio, M.D.

  • Geriatric Psychiatry Physician
  • Redlands, CA
National Provider Identifier
1255519849
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
A110358 Issued in CA
Practice address
1686 Barton Rd
Redlands, CA 92373-1488
Phone
(714) 330-3545
NPI assigned
Feb 5, 2008
Last updated
Jan 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X A110358 CA Primary

Addresses

Primary practice location

1686 Barton Rd
Redlands, CA 92373-1488

Mailing address

1686 Barton Rd
Redlands, CA 92373-1488
Phone (909) 558-9551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120924000066 CA Practitioner - Psychiatry 5395993992 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A110358CAMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince May 1, 2022 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince May 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2014 Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Interoperability endpoints

  • Direct secure messaging: cosorio53530@direct.llu.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1255519849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 BARTON RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731488",
            "telephone_number": "909-558-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 BARTON RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731488",
            "telephone_number": "714-330-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "CAROLINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "A110358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.