Provider Demographics
NPI:1821376492
Name:NODAL, SONIA BARBARA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:BARBARA
Last Name:NODAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 801742
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-1742
Mailing Address - Country:US
Mailing Address - Phone:818-947-2918
Mailing Address - Fax:818-947-2920
Practice Address - Street 1:15107 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4542
Practice Address - Country:US
Practice Address - Phone:818-947-2918
Practice Address - Fax:818-947-2920
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16128363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant