Provider Demographics
NPI:1417980855
Name:PASTRANA, SONIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:PASTRANA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NASA PKWY STE 308
Mailing Address - Street 2:HOUSTON
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3356
Mailing Address - Country:US
Mailing Address - Phone:281-691-3700
Mailing Address - Fax:281-857-6347
Practice Address - Street 1:1100 NASA PKWY
Practice Address - Street 2:SUITE 308
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3325
Practice Address - Country:US
Practice Address - Phone:281-691-3700
Practice Address - Fax:281-857-6347
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4165LCOtherBLUE CROSS BLUE SHIELD