Individual provider Active NPI

Athena Sofia Marinos, RN

  • Registered Nurse
  • El Cajon, CA
National Provider Identifier
1396460283
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
768378 Issued in CA
Practice address
11354 Via Rancho San Diego Unit a
El Cajon, CA 92019-5203
Phone
(619) 241-0028
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 768378 CA Primary

Addresses

Primary practice location

11354 Via Rancho San Diego Unit a
El Cajon, CA 92019-5203

Mailing address

11354 Via Rancho San Diego Unit a
El Cajon, CA 92019-5203
Phone (619) 241-0028

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
768378CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1396460283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11354 VIA RANCHO SAN DIEGO UNIT A",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920195203",
            "telephone_number": "619-241-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11354 VIA RANCHO SAN DIEGO UNIT A",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920195203",
            "telephone_number": "619-241-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINOS",
        "first_name": "ATHENA",
        "middle_name": "SOFIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "768378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.