Provider Demographics
NPI:1659409506
Name:SORENSON, PATRICIA MARIE (RNC MSN CNS NNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIE
Last Name:SORENSON
Suffix:
Gender:F
Credentials:RNC MSN CNS NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2481 VIA MARIPOSA
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4421
Mailing Address - Country:US
Mailing Address - Phone:626-915-2137
Mailing Address - Fax:626-915-3209
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA205257363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal