Active NPI
Charity Siasoco, RT (R) (M)
- Mammography Radiologic Technologist
- Coronado, CA
National Provider Identifier
1134413768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mammography Radiologic Technologist
- License
- 311095
- Practice address
- 438 Orange Ave
Coronado, CA 92118-1847 - Phone
- (619) 252-3653
- NPI assigned
- May 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiography Radiologic Technologist | 2471C3402X | 311095 | MI | |
| Mammography Radiologic Technologist | 2471M2300X | 311095 | MI | Primary |
Addresses
Primary practice location
438 Orange Ave
Coronado, CA 92118-1847
Mailing address
438 Orange Ave
Coronado, CA 92118-1847
Phone (619) 252-3653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311095 | MI | MD | Radiography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306800000000",
"number": "1134413768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 ORANGE AVE",
"city": "CORONADO",
"state": "CA",
"postal_code": "921181847",
"telephone_number": "619-252-3653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 ORANGE AVE",
"city": "CORONADO",
"state": "CA",
"postal_code": "921181847",
"telephone_number": "619-252-3653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIASOCO",
"first_name": "CHARITY",
"credential": "RT (R) (M)",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-31",
"last_updated": "2011-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "MI",
"license": "311095",
"primary": false
},
{
"code": "2471M2300X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Mammography",
"state": "MI",
"license": "311095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coronado, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.