Provider Demographics
NPI:1003023490
Name:SORKIN, ADELINA RUTH (LCSW)
Entity Type:Individual
Prefix:PROF
First Name:ADELINA
Middle Name:RUTH
Last Name:SORKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-3042
Mailing Address - Country:US
Mailing Address - Phone:323-661-6459
Mailing Address - Fax:
Practice Address - Street 1:1460 N LAKE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2300
Practice Address - Country:US
Practice Address - Phone:626-398-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS6265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS6265OtherLIC CLINICAL SOCIAL WORK