Individual provider Active NPI

Shena Unsoo Cacho, RN, BSN, PHN

  • Medical-Surgical Registered Nurse
  • San Diego, CA
National Provider Identifier
1225797855
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
95199887 Issued in CA
Practice address
5630 Overland Ave
San Diego, CA 92123
Phone
(619) 236-2191
NPI assigned
Dec 10, 2021
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
College Health Registered Nurse 163WC1400X 561785 CA
Medical-Surgical Registered Nurse 163WM0705X 95199887 CA Primary
Oncology Registered Nurse 163WX0200X 796201 CA

Addresses

Primary practice location

5630 Overland Ave
San Diego, CA 92123

Mailing address

1363 Vallejo Mills St
Chula Vista, CA 91913-2939
Phone (858) 354-6705

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
561785CAMDCollege Health Registered Nurse
95199887CAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1225797855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 VALLEJO MILLS ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919132939",
            "telephone_number": "858-354-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 OVERLAND AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "619-236-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACHO",
        "first_name": "SHENA",
        "middle_name": "UNSOO",
        "credential": "RN, BSN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, College Health",
            "state": "CA",
            "license": "561785",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "95199887",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "CA",
            "license": "796201",
            "primary": false
        }
    ],
    "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 Dec 10, 2021; 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.