Individual provider Active NPI

Sophia Ceulemans, M.S

  • Genetic Counselor (M.S.)
  • San Diego, CA
National Provider Identifier
1255728713
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
GC000621 Issued in CA
Practice address
7920 Frost St
Ste 200
San Diego, CA 92123-2736
Phone
(858) 966-8583
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X GC000621 CA Primary

Addresses

Primary practice location

7920 Frost St
Ste 200
San Diego, CA 92123-2736

Mailing address

3020 Childrens Way # Mc5031
San Diego, CA 92123-4223

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

LicenseStateTypeSpecialty
GC000621CAMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1255728713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5031",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 FROST ST",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232736",
            "telephone_number": "858-966-8583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEULEMANS",
        "first_name": "SOPHIA",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "CA",
            "license": "GC000621",
            "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 Apr 24, 2015; 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.