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KEN SORYADVONGSA
NPI 1295469930
Counselor - Mental Health in San Diego, CA

Active since July 09, 2022
928 BROADWAY, SAN DIEGO, CA 92101(619) 977-3716 Get Directions Write a Review

NPPES record last updated: July 15, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 15, 2022, Jul 9, 2022 (2 updates tracked since 2022).

About Ken Soryadvongsa NPPES

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

KEN SORYADVONGSA (NPI 1295469930) is an individual mental health provider in San Diego, California and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1295469930
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameKEN SORYADVONGSA
Location Address928 BROADWAYSan Diego, CA 92101-5514
Mailing Address928 BroadwaySan Diego, CA 92101-5514 · (619) 977-3716
Phone(619) 977-3716
Sole ProprietorNo
Enumeration DateJuly 9, 2022
Last NPPES UpdateJuly 15, 20222 updates tracked since enumeration
NPPES CertifiedJuly 15, 2022
✔ NPI 1295469930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
928 BROADWAY, San Diego, CA 92101
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Other Providers at the Same Location NPPES 20

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

KASSANDRA MARIE BARACEROS RN
Registered Nurse
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 275-0822
BRENDA GOODRICH
Day Training/Habilitation Specialist
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716
YAHAIRA KARELY TUBI
Counselor (Mental Health)
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716
ANGEL OLAYO ESPINOZA
Day Training/Habilitation Specialist
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716
ZOEY HANNA DARBY
Case Manager/Care Coordinator
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716
LILI-ANN MARIE MOONEYHAM
Rehabilitation Practitioner
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716
MARIAM KIARA LOWE
Counselor (Mental Health)
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716
LANA BARAKAT
Counselor (Mental Health)
928 BROADWAY
SAN DIEGO, CA 92101
San Diego County (619) 977-3716

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 Ken Soryadvongsa's NPI number?

The NPI number for Ken Soryadvongsa is 1295469930. It was assigned to this individual provider in the NPPES registry on July 9, 2022.

Where is Ken Soryadvongsa located?

Ken Soryadvongsa practices at 928 Broadway, San Diego, CA 92101. The listed phone number is (619) 977-3716.

What is Ken Soryadvongsa's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Ken Soryadvongsa was last updated on July 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.