Kasey Souvannaleuth

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Practice address

28289 Broken Arrow Way
Murrieta, CA 92563-9256

Phone

(619) 609-1616

NPI assigned

Feb 21, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1881450518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29298 BROKEN ARROW WAY",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632721",
            "telephone_number": "619-609-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28289 BROKEN ARROW WAY",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925639256",
            "telephone_number": "619-609-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUVANNALEUTH",
        "first_name": "KASEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Nurse's Aide in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.