Individual provider Active NPI

Sonnier Faye Sibley, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1598286536
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56521 Issued in CA
Practice address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone
(619) 906-4623
NPI assigned
Jun 29, 2017
Last updated
May 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 197687 OR
Physician Assistant 363A00000X 6735 AZ
Physician Assistant 363A00000X 56521 CA Primary

Addresses

Primary practice location

823 Gateway Center Way
San Diego, CA 92102-4541

Mailing address

111 Bank St # 162
Grass Valley, CA 95945-6518
Phone (928) 240-8279

Other practice location 1

320 E Deuce of Clubs
Show Low, AZ 85901
Phone (928) 532-3926

Other practice location 2

1550 Broadway Ste 2
San Diego, CA 92101-5713
Phone (619) 515-2525

Other names 1

  • Sonnier Faye Vander Ploeg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200206002817 CA Practitioner - Physician Assistant 3072884535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3514 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

3544 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
197687ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Apr 16, 2023 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Apr 16, 2023 Accepting new patients

Locations

1550 Broadway
#2
San Diego, CA 92101
Phone (619) 515-2525

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1598286536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BANK ST # 162",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959456518",
            "telephone_number": "928-240-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E Deuce of Clubs",
            "address_purpose": "LOCATION",
            "city": "Show Low",
            "state": "AZ",
            "postal_code": "85901",
            "country_code": "US",
            "telephone_number": "928-532-3926",
            "fax_number": "928-537-9634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 Broadway Ste 2",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921015713",
            "country_code": "US",
            "telephone_number": "619-515-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "SONNIER",
        "middle_name": "FAYE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "197687",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6735",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONNIER",
            "last_name": "VANDER PLOEG",
            "middle_name": "FAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.