Provider Demographics
NPI:1275931586
Name:SORENSEN, SANDEE (HIS)
Entity Type:Individual
Prefix:MRS
First Name:SANDEE
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 VILLAGE LN STE 204
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2277
Mailing Address - Country:US
Mailing Address - Phone:805-688-8566
Mailing Address - Fax:
Practice Address - Street 1:2027 VILLAGE LN STE 204
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2277
Practice Address - Country:US
Practice Address - Phone:805-688-8566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2826237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist