Provider Demographics
NPI:1174002299
Name:SORKIN, TERI (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:
Last Name:SORKIN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4327
Mailing Address - Country:US
Mailing Address - Phone:925-337-4810
Mailing Address - Fax:
Practice Address - Street 1:1615 SECOND ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4327
Practice Address - Country:US
Practice Address - Phone:925-337-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT49267101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health