Individual provider Active NPI

Sounthary Roques, RN

  • Case Management Registered Nurse
  • San Bernardino, CA
National Provider Identifier
1720978661
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
95085621 Issued in CA
Practice address
330 N D St # 320
San Bernardino, CA 92401-1545
Phone
(909) 893-2782
NPI assigned
Jul 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 95085621 CA Primary
Community Health Registered Nurse 163WC1500X 95085621 CA
Neonatal Intensive Care Registered Nurse 163WN0002X 95085621 CA
Pediatric Registered Nurse 163WP0200X 95085621 CA

Addresses

Primary practice location

330 N D St # 320
San Bernardino, CA 92401-1545

Mailing address

14783 Green Lawn Dr
Moreno Valley, CA 92555-5744
Phone (909) 809-1160

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
95085621CAMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1720978661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14783 GREEN LAWN DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925555744",
            "telephone_number": "909-809-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N D ST # 320",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011545",
            "telephone_number": "909-893-2782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUES",
        "first_name": "SOUNTHARY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "95085621",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "95085621",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "CA",
            "license": "95085621",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "95085621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.