Provider Demographics
NPI:1508018201
Name:JULIE K. SORENSEN CHIROPRACTIC,INC
Entity Type:Organization
Organization Name:JULIE K. SORENSEN CHIROPRACTIC,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-915-3434
Mailing Address - Street 1:2720 COCHRAN ST.
Mailing Address - Street 2:SUITE 5B ST
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-915-3434
Mailing Address - Fax:
Practice Address - Street 1:2720 COCHRAN ST STE 5B
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2781
Practice Address - Country:US
Practice Address - Phone:805-915-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV02304Medicare UPIN
CAWDC28290AMedicare PIN