| Doreen Kellie Carrillo, FNP | |
|
582 E Harding Way, Stockton, CA 95204-6110 | |
| (888) 530-4415 | |
| Not Available |
| Full Name | Doreen Kellie Carrillo |
|---|---|
| Gender | Female |
| Speciality | Registered Nurse |
| Location | 582 E Harding Way, Stockton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851948046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 95012375 (California) | Primary |
| Entity Name | SNF Wound Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114393311 PECOS PAC ID: 1759699176 Enrollment ID: O20151006000251 |
| Mailing Address | Practice Location Address |
|---|---|
| Doreen Kellie Carrillo, FNP 582 E Harding Way, Stockton, CA 95204-6110 Ph: (209) 373-5445 | Doreen Kellie Carrillo, FNP 582 E Harding Way, Stockton, CA 95204-6110 Ph: (888) 530-4415 |
Ms. Delia Ordaz, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1212 N California St, Stockton, CA 95202 Phone: 209-468-3760 Fax: 209-468-3779 |
Aurora Kay Pettett, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4555 Precissi Ln, Stockton, CA 95207 Phone: 209-477-4103 Fax: 209-477-1065 |
Arunny Hin-serapheap, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1212 N California St, Stockton, CA 95202 Phone: 209-468-8663 |
Mr. David Allan Rutter, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1588 E March Ln, Stockton, CA 95210 Phone: 207-474-7881 Fax: 913-814-4525 |
Mrs. Ruby Ann Aurea Cubangbang, NP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2429 Rajkovich Way, Stockton, CA 95212 Phone: 209-598-3125 |
Ms. Debra L. Grinstead, R. N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1212 N California St, Stockton, CA 95202 Phone: 209-468-8843 |
Mr. Raffy Oliver J. Buenaventura, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 427 W Lincoln Rd, Stockton, CA 95207 Phone: 209-406-0834 |