Active NPI
Queenie Soriano, MS, ATC
- Athletic Trainer
- San Diego, CA
National Provider Identifier
1205325065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 080402365
- Practice address
- 5500 Campanile Dr
San Diego, CA 92182-0001 - Phone
- (619) 594-1339
- NPI assigned
- May 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 080402365 | CA | Primary |
Addresses
Primary practice location
5500 Campanile Dr
San Diego, CA 92182-0001
Mailing address
8510 Lemon Ave
La Mesa, CA 91941-5312
Phone (505) 331-3025
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 080402365 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1205325065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8510 LEMON AVE",
"city": "LA MESA",
"state": "CA",
"postal_code": "919415312",
"telephone_number": "505-331-3025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 CAMPANILE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921820001",
"telephone_number": "619-594-1339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORIANO",
"first_name": "QUEENIE",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "080402365",
"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 May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.