Individual provider Active NPI

Corey Akoni Cabulagan, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1639833460
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95018506 Issued in CA
Practice address
3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone
(858) 642-3011
NPI assigned
Oct 27, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95018506 CA Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
San Diego, CA 92161-0002

Mailing address

46010 Clubhouse Dr
Temecula, CA 92592-6042
Phone (760) 500-9476

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
I20230125002596 CA Practitioner - Nurse Practitioner 9931570173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

5060 Shoreham PL
Suite 330
San Diego, CA 92122-5976
Phone (858) 427-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018506CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC CurrentSince Nov 1, 2022 Accepting new patients
Shashita Inamdar MD Professional Corporation Past Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

2386 Faraday Ave
Ste 111
Carlsbad, CA 92008

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

Interoperability endpoints

  • Direct secure messaging: corey.cabulagan.p1@direct.sokya.nextgenshare.com

Organizations & group practices 2

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1639833460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46010 CLUBHOUSE DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926042",
            "telephone_number": "760-500-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-642-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABULAGAN",
        "first_name": "COREY",
        "middle_name": "AKONI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95018506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.