Organization Active NPI

Sober Life Recovery Solutions LLC

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
National Provider Identifier
1083586523
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SOBER LIFE RECOVERY SOLUTIONS LLC
Practice address
8619 Jackie Dr
San Diego, CA 92119-1414
Phone
(619) 542-9542
Fax
(619) 566-4979
NPI assigned
Sep 23, 2025
Organization subpart
Yes
Parent organization
SOBER LIFE RECOVERY SOLUTIONS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Deomel Soriano, PMHNP
Title
Ceo
Phone
(619) 542-9542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

8619 Jackie Dr
San Diego, CA 92119-1414

Mailing address

3930 4TH Ave Ste 300
San Diego, CA 92103-3119
Phone (619) 542-9542

Other names 1

  • Hidden Leaf Wellness Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2344281Sober Life Recovery Solutions LLC8619 Jackie Dr, San Diego, CA 92119Certificate of waiverMay 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Sober Life Recovery Solutions LLC3 organizations share this tax ID, including this one
Part of
Sober Life Recovery Solutions LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1083586523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 4TH AVE STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033119",
            "telephone_number": "619-542-9542",
            "fax_number": "619-566-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 JACKIE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191414",
            "telephone_number": "619-542-9542",
            "fax_number": "619-566-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER LIFE RECOVERY SOLUTIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOBER LIFE RECOVERY SOLUTIONS LLC",
        "enumeration_date": "2025-09-23",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "SORIANO",
        "authorized_official_first_name": "DEOMEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-542-9542",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hidden Leaf Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.