Provider Demographics
NPI:1134913676
Name:CONDE, SOPHIA DANIELA (MSW)
Entity type:Individual
Prefix:MS
First Name:SOPHIA
Middle Name:DANIELA
Last Name:CONDE
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21250 BOX SPRINGS RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-8707
Mailing Address - Country:US
Mailing Address - Phone:951-357-6897
Mailing Address - Fax:
Practice Address - Street 1:21250 BOX SPRINGS RD STE 106
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-8707
Practice Address - Country:US
Practice Address - Phone:951-357-6897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker