Individual provider Active NPI

Carmen Storey, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Moreno Valley, CA
National Provider Identifier
1710130042
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95036315 Issued in CA
Practice address
15364 Avenida Anillo
Moreno Valley, CA 92555-4108
Phone
(951) 388-4428
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 772466 CA
Gerontology Nurse Practitioner 363LG0600X 95036315 CA
Adult Health Nurse Practitioner 363LA2200X 95036315 CA Primary

Addresses

Primary practice location

15364 Avenida Anillo
Moreno Valley, CA 92555-4108

Mailing address

15364 Avenida Anillo
Moreno Valley, CA 92555-4108
Phone (951) 388-4428

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260202003209 CA Practitioner - Nurse Practitioner 5395223143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

136 E Walnut Ave
Monrovia, CA 91016-3431

15364 Avenida Anillo
Moreno Valley, CA 92555-4108

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
772466CAMDMedical-Surgical Registered Nurse
95036315CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Wound Care CurrentSince Dec 21, 2025 Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Feb 1, 2026 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

136 E Walnut Ave
Monrovia, CA 91016
Phone (323) 803-3284

1651 Response Rd
Ste 350
Sacramento, CA 95815
Phone (818) 450-1188

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1710130042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15364 AVENIDA ANILLO",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554108",
            "telephone_number": "951-388-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15364 AVENIDA ANILLO",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554108",
            "telephone_number": "951-388-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOREY",
        "first_name": "CARMEN",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "772466",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95036315",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95036315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.