Provider Demographics
NPI:1497984751
Name:SORRENTINO, RICHARD (ATR)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SORRENTINO
Suffix:
Gender:M
Credentials:ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ALMA AVE
Mailing Address - Street 2:STE 417
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5044
Mailing Address - Country:US
Mailing Address - Phone:512-658-7850
Mailing Address - Fax:
Practice Address - Street 1:1310 ALMA AVE
Practice Address - Street 2:STE 417
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5044
Practice Address - Country:US
Practice Address - Phone:512-658-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health