Provider Demographics
NPI:1922455203
Name:SORIANO, KIMBERLY GRACE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:GRACE
Last Name:SORIANO
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1559 E AMAR RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1679
Mailing Address - Country:US
Mailing Address - Phone:626-810-1522
Mailing Address - Fax:626-810-2793
Practice Address - Street 1:1559 E AMAR RD
Practice Address - Street 2:SUITE F
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1679
Practice Address - Country:US
Practice Address - Phone:626-810-1522
Practice Address - Fax:626-810-2793
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95004264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily