Provider Demographics
NPI:1538105119
Name:SORIANO, MARCEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCEL
Middle Name:
Last Name:SORIANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 MILLIKEN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6780
Mailing Address - Country:US
Mailing Address - Phone:909-944-3559
Mailing Address - Fax:909-944-3546
Practice Address - Street 1:7777 MILLIKEN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6780
Practice Address - Country:US
Practice Address - Phone:909-944-3559
Practice Address - Fax:909-944-3546
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11559103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist