Renee M. Soderquist, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

R711364 Issued in CA

Practice address

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3813

Phone

(714) 446-5640

Fax

(714) 446-5625

NPI assigned

Jun 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1124280557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR",
            "address_2": "SUITE 105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353813",
            "telephone_number": "714-446-5640",
            "fax_number": "714-446-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR",
            "address_2": "SUITE 105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353813",
            "telephone_number": "714-446-5640",
            "fax_number": "714-446-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERQUIST",
        "first_name": "RENEE",
        "middle_name": "M.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "R711364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD LIC NUMBER",
            "identifier": "R711364",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Africa S So, MD
• Noelle Madison Keh So
• Soar Behavior Services, Inc.
• Carlos Sobral, MD
• Eric Soderquist
• Cheryl Lynne Sogbesan
• Julianna Chhorani Sok
• Paula Jacqueline Solano
• Saidee Solano
• Shahram Solhpour, MD

• Registered Dietitian in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.