Provider Demographics
NPI:1093888042
Name:SORENSEN, KIMBERLY ANNETTE (C-FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNETTE
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1606
Mailing Address - Country:US
Mailing Address - Phone:805-722-1511
Mailing Address - Fax:805-965-2292
Practice Address - Street 1:518 GARDEN ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1606
Practice Address - Country:US
Practice Address - Phone:805-722-1511
Practice Address - Fax:805-965-2292
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14600363LF0000X
FL9349406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily