Provider Demographics
NPI:1841543758
Name:SOHN, CASSANDRA NADEAN (HHP, MT)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:NADEAN
Last Name:SOHN
Suffix:
Gender:F
Credentials:HHP, MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2074
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91943-2074
Mailing Address - Country:US
Mailing Address - Phone:619-985-7153
Mailing Address - Fax:
Practice Address - Street 1:7866 LA MESA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0633
Practice Address - Country:US
Practice Address - Phone:619-985-7153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA014263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1143256OtherAMERICAN SPECIALTY HEALTH
12424667OtherCAQH