Doreen Kellie Carrillo, FNP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95012375 Issued in CA

Practice address

582 E Harding Way
Stockton, CA 95204-6110

Phone

(888) 530-4415

NPI assigned

Aug 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: doreen.carrillo.8@17371.direct.athenahealth.com

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

• SNF Wound Care

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1114393311
  Medicare reassignment NPD

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1851948046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "209-373-5445",
            "fax_number": "844-226-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "888-530-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "DOREEN",
        "middle_name": "KELLIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95012375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esmeralda Carrillo Pineda, RDN
• Irene Carrillo Venegas
• Benjamin Ray Carrillo
• Brenda Carrillo
• Diana Carrillo
• Monique Josephine Carrillo
• Rebeca Elizabeth Carrillo
• Rubi Carrillo
• Zulema Carrillo
• Arlette Carrion

• Registered Nurse in Stockton, CA
• Providers in Stockton, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.