Provider Demographics
NPI:1992196471
Name:SORGE, PATRIZIA (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRIZIA
Middle Name:
Last Name:SORGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N CENTRAL AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2021
Mailing Address - Country:US
Mailing Address - Phone:310-420-0078
Mailing Address - Fax:
Practice Address - Street 1:23822 VALENCIA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5345
Practice Address - Country:US
Practice Address - Phone:310-420-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical