Provider Demographics
NPI:1093190332
Name:REINECKE, SONJA (MA)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:REINECKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5701 LONETREE BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3794
Mailing Address - Country:US
Mailing Address - Phone:916-943-6574
Mailing Address - Fax:
Practice Address - Street 1:5701 LONETREE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3794
Practice Address - Country:US
Practice Address - Phone:916-943-6574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87414106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist