Provider Demographics
NPI:1134373525
Name:PARROTT, SONYA NICOLE (MFC 53257)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:NICOLE
Last Name:PARROTT
Suffix:
Gender:F
Credentials:MFC 53257
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2503
Mailing Address - Country:US
Mailing Address - Phone:916-626-4305
Mailing Address - Fax:916-357-9867
Practice Address - Street 1:1122 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2503
Practice Address - Country:US
Practice Address - Phone:916-626-4305
Practice Address - Fax:916-357-9867
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF58952106H00000X
171M00000X
CAMFC 53257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
000008462OtherMEDICAL PROVIDER NUMBER