Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ken Soryadvongsa

Individual provider Mental Health Counselor · NPI 1295469930

Ken Soryadvongsa is a Mental Health Counselor in San Diego, California. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

928 Broadway
San Diego, CA 92101-5514
Phone: (619) 977-3716
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1295469930
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 9, 2022
Last updated in NPPESJuly 15, 2022
Certification dateJuly 15, 2022

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