Provider Demographics
NPI:1184314858
Name:SORDILLA, FREDERICK KARLO TIRONA (FNP-C)
Entity type:Individual
Prefix:
First Name:FREDERICK KARLO
Middle Name:TIRONA
Last Name:SORDILLA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 HOLLY CT
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-7402
Mailing Address - Country:US
Mailing Address - Phone:559-380-6498
Mailing Address - Fax:
Practice Address - Street 1:231 W NOBLE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2631
Practice Address - Country:US
Practice Address - Phone:559-635-7100
Practice Address - Fax:559-635-7104
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily