Provider Demographics
NPI:1023559051
Name:THAKORE, SONALI MANAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:MANAN
Last Name:THAKORE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 GLENFOX DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6522
Mailing Address - Country:US
Mailing Address - Phone:909-268-5721
Mailing Address - Fax:
Practice Address - Street 1:12462 PUTNAM ST., # 206
Practice Address - Street 2:PIH HEALTH HEMATOLOGY ONCOLOGY
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1049
Practice Address - Country:US
Practice Address - Phone:562-789-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily