Provider Demographics
NPI:1932497906
Name:MILKIN, SONIA LENTZ (PHD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:LENTZ
Last Name:MILKIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:ANNE
Other - Last Name:LENTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 CAMINO DE LA REINA APT 114
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3271
Mailing Address - Country:US
Mailing Address - Phone:781-793-4606
Mailing Address - Fax:
Practice Address - Street 1:20 NORTH SAN PEDRO ROAD, SUITE 2021
Practice Address - Street 2:COUNTY MHSUS
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903
Practice Address - Country:US
Practice Address - Phone:781-793-4606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 390200000X
CAPSY30216103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program