Provider Demographics
NPI:1639551351
Name:SORIANO, MICHELLE GRACE (NP-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:GRACE
Last Name:SORIANO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14378 CASCADE CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-6204
Mailing Address - Country:US
Mailing Address - Phone:661-373-5301
Mailing Address - Fax:
Practice Address - Street 1:14378 CASCADE CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91387-6204
Practice Address - Country:US
Practice Address - Phone:661-373-5301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily