Individual provider Active NPI

Souraya Lorenz, AU.D.

  • Audiologist
  • San Diego, CA
National Provider Identifier
1033717715
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU3563 Issued in CA
Practice address
12395 El Camino Real Ste 305
San Diego, CA 92130-3085
Phone
(858) 554-9933
Fax
(858) 481-8027
NPI assigned
Oct 14, 2020
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU3563 CA Primary

Addresses

Primary practice location

12395 El Camino Real Ste 305
San Diego, CA 92130-3085

Mailing address

12395 El Camino Real Ste 305
San Diego, CA 92130-3085
Phone (858) 554-9933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210118000091 CA Practitioner - Qualified Audiologist 3375956162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Louisville School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

12395 El Camino Real
Suite 112
San Diego, CA 92130-3084
Phone (858) 554-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU3563CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Hearing and Balance Corp CurrentSince Oct 8, 2020 Accepting new patients
Scripps Health CurrentSince Nov 8, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Nov 8, 2021 Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

2205 Vista Way
Oceanside, CA 92054
Phone (760) 704-5400

12395 El Camino Real
Ste 112
San Diego, CA 92130
Phone (619) 670-5400

12395 El Camino Real
Ste 305
San Diego, CA 92130
Phone (858) 554-9933

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

6229 W 87th St
Westchester, CA 90045
Phone (310) 677-1168

Organizations & group practices 4

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1033717715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL STE 305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303085",
            "telephone_number": "858-554-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL STE 305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303085",
            "telephone_number": "858-554-9933",
            "fax_number": "858-481-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "SOURAYA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU3563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.