Jeffrey Souza, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95007688 Issued in CA

Practice address

2 Scripps Dr Ste 202
Sacramento, CA 95825-6207

Phone

(916) 436-3015

Fax

(916) 436-3042

NPI assigned

Feb 15, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Active Life Wound Center a Professional Medical Corporation

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1396553616

  Wound Care

  Medicare reassignment NPD Authorized official
• Active Life Wound Clinic a Professional Nursing Corporation

  • Nurse Practitioner
  • Sacramento, CA
  • NPI 1801253323

  Single Specialty

  Medicare reassignment NPD
• Pain and Rehabilitative Consultants Medical Group

  • Interventional Pain Medicine Physician
  • Emeryville, CA
  • NPI 1952466963

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1831558196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661587",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958661587",
            "telephone_number": "916-436-3015",
            "fax_number": "916-436-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SCRIPPS DR STE 202",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256207",
            "telephone_number": "916-436-3015",
            "fax_number": "916-436-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "JEFFREY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-15",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007688",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN328206",
            "primary": false
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "CA",
            "license": "RN320206",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95007688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRN",
            "identifier": "NP95007688",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRN",
            "identifier": "RN328206",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saysomboun Souvannarath
• Souvenir Hospice and Palliative Care, Inc.
• Dapphney Souverain, FNP-BC
• Ashley Souza
• Elaine Souza, RD
• Jonathan Souza
• Lindsay Souza
• Raya Souza
• Rebecca Souza
• Melissa Rose Payton Sowe

• Family Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.