Sofie PHD Psychology Co

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOFIE PHD PSYCHOLOGY CO

Practice address

3505 Camino del Rio S Ste 212
San Diego, CA 92108-4016

Phone

(619) 722-5797

NPI assigned

Apr 20, 2020

Last updated

Jul 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sofie Ling ChampassakNPI 1114405305

Title

Owner

Phone

(619) 722-5797

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sofie Ling Champassak, PHD

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1114405305
  Medicare reassignment NPD Authorized official
• Ellen Patricia Lacter, PH.D.

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1447274881
  NPD (past)

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1518587526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26331",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921960331",
            "telephone_number": "619-722-5797",
            "fax_number": "619-354-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 CAMINO DEL RIO S STE 212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084016",
            "telephone_number": "619-722-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOFIE PHD PSYCHOLOGY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-20",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "CHAMPASSAK",
        "authorized_official_first_name": "SOFIE",
        "authorized_official_middle_name": "LING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-722-5797"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily M Socola-McCormick, MA
• Dustin Soderberg
• Paula Harriet Soderberg
• Matthew F Soeherman, DDS
• Beth Ann Soelberg, PT, DPT
• Max Oscar Soghikian, MD
• Irem Sogutlugil
• Govinder Kaur Sohal, FNP
• Soham Chiropractic Corp
• Vivek Soham, DC, CME

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.