Individual provider Active NPI

Sherry Soefje, M.D.

  • Psychiatry Physician
  • Oceanside, CA
National Provider Identifier
1639260201
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A52993 Issued in CA
Practice address
3998 Vista Way
Suite D
Oceanside, CA 92056-4500
Phone
(760) 806-1800
Fax
(760) 806-1801
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A52993 CA Primary
Mental Health Counselor 101YM0800X A52993 CA

Addresses

Primary practice location

3998 Vista Way
Suite D
Oceanside, CA 92056-4500

Mailing address

3998 Vista Way Ste 100
Oceanside, CA 92056-4515
Phone (760) 758-2222

Other practice location 1

3012 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1972
Phone (702) 527-7401

Other identifiers 3

IdentifierTypeStateIssuer
14446OtherNVNEVADA STATE BOARD OF MEDICAL EXAMINERS
CS25002OtherNVBOARD OF PHARMACY
00A529930MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 22, 2016 through Jun 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A52993CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arch Health Partners, Inc Psychiatry Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639260201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 VISTA WAY STE 100",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564515",
            "telephone_number": "760-758-2222",
            "fax_number": "760-758-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 VISTA WAY",
            "address_2": "SUITE D",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564500",
            "telephone_number": "760-806-1800",
            "fax_number": "760-806-1801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3012 W Charleston Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021972",
            "country_code": "US",
            "telephone_number": "702-527-7401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOEFJE",
        "first_name": "SHERRY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A52993",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "A52993",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF MEDICAL EXAMINERS",
            "identifier": "14446",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "CS25002",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A529930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.