Active NPI
Sokha Phe, NURSE PRACTITIONER
- Nurse Practitioner
- Long Beach, CA
National Provider Identifier
1871939009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 646268
- Practice address
- 1333 Chestnut Ave
Long Beach, CA 90813-2944 - Phone
- (562) 599-2153
- NPI assigned
- May 14, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 646268 | CA | Primary |
Addresses
Primary practice location
1333 Chestnut Ave
Long Beach, CA 90813-2944
Mailing address
1061 Walnut Ave
Apt # 218
Long Beach, CA 90813-3871
Phone (562) 225-9880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689695892 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181129002354 | CA | Order and Referring Only - Nurse Practitioner | 5799029864 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18816 | CA | MD | Psychiatry Physician |
| 646268 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1871939009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 WALNUT AVE",
"address_2": "APT # 218",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133871",
"telephone_number": "562-225-9880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 CHESTNUT AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908132944",
"telephone_number": "562-599-2153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHE",
"first_name": "SOKHA",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-14",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "646268",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689695892",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.