Khwanthida Soonthornpong, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95032334 Issued in CA

Practice address

9388 Lightwave Ave
San Diego, CA 92123-1426

Phone

(858) 541-7710

NPI assigned

Apr 14, 2022

Last updated

Apr 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1053054361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-647-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9388 LIGHTWAVE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231426",
            "telephone_number": "858-541-7710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Flower St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927032361",
            "country_code": "US",
            "telephone_number": "714-647-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOONTHORNPONG",
        "first_name": "KHWANTHIDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032334",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95235554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sooil LLC (Sooil USA)
• Jessica Norie Soon Prado, LMFT
• Seaver Lee Soon, M.D.
• John J Soong, MD
• Sumana Soonthorn
• Scott Soots, IDC
• Elizabeth Sophy
• Sophya Nadya Morghem DMD Ms
• Zachary Sopko, MS, RN
• Didrik Johannes Sopler, PH.D., L.AC.

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.