Provider Demographics
NPI:1669628566
Name:SOSENKO, LAUREN PAFUMI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:PAFUMI
Last Name:SOSENKO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1445 BUTTE HOUSE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-2749
Mailing Address - Country:US
Mailing Address - Phone:530-751-1122
Mailing Address - Fax:530-751-1122
Practice Address - Street 1:1445 BUTTE HOUSE RD
Practice Address - Street 2:SUITE F
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2749
Practice Address - Country:US
Practice Address - Phone:530-751-1122
Practice Address - Fax:530-751-1122
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25005103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical