Individual provider Active NPI

Anna Marie Soriano-Samson, NP-C

  • Family Nurse Practitioner
  • Lake Elsinore, CA
National Provider Identifier
1902150865
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21743 Issued in CA
Practice address
31736 Mission TRL Ste G
Lake Elsinore, CA 92530-4533
Phone
(951) 674-1505
NPI assigned
Oct 31, 2012
Last updated
Apr 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21743 CA Primary

Addresses

Primary practice location

31736 Mission TRL Ste G
Lake Elsinore, CA 92530-4533

Mailing address

31736 Mission TRL Ste G
Lake Elsinore, CA 92530-4533
Phone (951) 674-1505

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627000565 CA Practitioner - Nurse Practitioner 4082839410 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21743CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard C. Lam, M.D., Inc. CurrentSince Apr 7, 2014 Accepting new patients
Bill L. Jou, M.D., Inc. CurrentSince Apr 7, 2014 Accepting new patients
Menifee Global Multi-Specialty Group Inc PastSince May 1, 2015 Accepting new patients

Locations

27994 Bradley Rd
Ste C
Sun City, CA 92586
Phone (909) 301-9339

31515 Rancho Pueblo Rd
Ste 205
Temecula, CA 92592
Phone (951) 676-8118

41900 Winchester Rd
Ste 100
Temecula, CA 92590
Phone (951) 676-2923

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1902150865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31736 MISSION TRL STE G",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304533",
            "telephone_number": "951-674-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31736 MISSION TRL STE G",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304533",
            "telephone_number": "951-674-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIANO-SAMSON",
        "first_name": "ANNA MARIE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

Verify at the official NPI Registry.