Individual provider Active NPI

Penny Soderlund, R.N.

  • Case Manager/Care Coordinator
  • Sacramento, CA
National Provider Identifier
1386838282
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
229284 Issued in CA
Practice address
9333 Tech Center Dr
Suite 800
Sacramento, CA 95826-2583
Phone
(916) 875-5000
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 229284 CA
Case Manager/Care Coordinator 171M00000X 229284 CA Primary

Addresses

Primary practice location

9333 Tech Center Dr
Suite 800
Sacramento, CA 95826-2583

Mailing address

7001A East Pkwy
Suite 600
Sacramento, CA 95823-2501
Phone (916) 875-5000

Other names 1

  • Penelope Soderlund Professional name

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
229284CAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1386838282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001A EAST PKWY",
            "address_2": "SUITE 600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232501",
            "telephone_number": "916-875-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 TECH CENTER DR",
            "address_2": "SUITE 800",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262583",
            "telephone_number": "916-875-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERLUND",
        "first_name": "PENNY",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "229284",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "229284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENELOPE",
            "last_name": "SODERLUND",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.