Provider Demographics
NPI:1265631188
Name:PEDROZA, SOMMER (FNP-C)
Entity Type:Individual
Prefix:
First Name:SOMMER
Middle Name:
Last Name:PEDROZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SOMMER
Other - Middle Name:
Other - Last Name:ZERMENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN
Mailing Address - Street 1:15975 HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1303
Mailing Address - Country:US
Mailing Address - Phone:714-546-6575
Mailing Address - Fax:
Practice Address - Street 1:15975 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1303
Practice Address - Country:US
Practice Address - Phone:714-546-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA622161163WC1500X, 163WM0102X, 163WS0200X
CA95022007363LF0000X, 363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health