Individual provider Active NPI

Krystal Khamthi Soukhaseum

  • Occupational Therapist
  • Oroville, CA
National Provider Identifier
1801767090
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
18785 Issued in CA
Practice address
2767 Olive Hwy
Oroville, CA 95966-6118
Phone
(530) 532-8310
NPI assigned
Sep 12, 2025
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 18785 CA Primary

Addresses

Primary practice location

2767 Olive Hwy
Oroville, CA 95966-6118

Mailing address

2349 Foothill Blvd
Oroville, CA 95966-5520

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

State licenses

LicenseStateTypeSpecialty
18785CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1801767090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 FOOTHILL BLVD",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959665520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-532-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUKHASEUM",
        "first_name": "KRYSTAL",
        "middle_name": "KHAMTHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "18785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.