Provider Demographics
NPI:1720088933
Name:SMITH, SONIA CARMEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:CARMEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:639 NORUMBEGA DR
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-1814
Mailing Address - Country:US
Mailing Address - Phone:626-357-9039
Mailing Address - Fax:626-284-9746
Practice Address - Street 1:880 S ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4700
Practice Address - Country:US
Practice Address - Phone:626-284-9278
Practice Address - Fax:626-284-9746
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2016-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN342860363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner