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KHWANTHIDA SOONTHORNPONG NP
NPI 1053054361
Nurse Practitioner - Family in San Diego, CA

Active since April 14, 2022
9388 LIGHTWAVE AVE, SAN DIEGO, CA 92123(858) 541-7710 Get Directions Write a Review

NPPES record last updated: April 10, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 10, 2025, Oct 8, 2024, Apr 14, 2022 (3 updates tracked since 2022).

About Khwanthida Soonthornpong Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHWANTHIDA SOONTHORNPONG NP (NPI 1053054361) is an individual family provider in San Diego, California, licensed in California (95032334) and active in the NPI registry since April 2022. She maintains a secondary practice location in Santa Ana.

NPPES Registry Identity

NPI1053054361
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKHWANTHIDA SOONTHORNPONGCredential: NP
Location Address9388 LIGHTWAVE AVESan Diego, CA 92123-1426
Mailing Address405 W 5th StSanta Ana, CA 92701-4599 · (714) 647-6092
Phone(858) 541-7710
Sole ProprietorNo
Enumeration DateApril 14, 2022
Last NPPES UpdateApril 10, 20253 updates tracked since enumeration
NPPES CertifiedApril 10, 2025
✔ NPI 1053054361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95032334
Also ListedRegistered NurseTaxonomy 163W00000X · License 95235554 (CA)
9388 LIGHTWAVE AVE, San Diego, CA 92123
Open in Google Maps ↗

Secondary Practice Location 1

Location 1550 N Flower StSanta Ana, CA 92703-2361 · Phone (714) 647-4666

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOYCE MEI WU
Student in an Organized Health Care Education/Training Program
9388 LIGHTWAVE AVE
SAN DIEGO, CA 92123
San Diego County (800) 628-8648
AMANDA LEIGH THOMPSON
Registered Nurse
9388 LIGHTWAVE AVE
SAN DIEGO, CA 92123
San Diego County (858) 642-8260
MS. JIAN RAMONA CASILLAS FNP
Student in an Organized Health Care Education/Training Program
9388 LIGHTWAVE AVE
SAN DIEGO, CA 92123
San Diego County (800) 628-8648
ANGEL IWUOMA
Nurse Practitioner (Psychiatric/Mental Health)
9388 LIGHTWAVE AVE
SAN DIEGO, CA 92123
San Diego County (800) 628-8648

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khwanthida Soonthornpong's NPI number?

The NPI number for Khwanthida Soonthornpong is 1053054361. It was assigned to this individual provider in the NPPES registry on April 14, 2022.

Where is Khwanthida Soonthornpong located?

Khwanthida Soonthornpong practices at 9388 Lightwave Ave, San Diego, CA 92123. The listed phone number is (858) 541-7710.

What is Khwanthida Soonthornpong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Khwanthida Soonthornpong was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.