Provider Demographics
NPI:1982783825
Name:PLONE, SONDRA -------------------- (PHD)
Entity Type:Individual
Prefix:DR
First Name:SONDRA
Middle Name:--------------------
Last Name:PLONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 WILSHIRE BLVD
Mailing Address - Street 2:STE. 304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1085
Mailing Address - Country:US
Mailing Address - Phone:310-979-7473
Mailing Address - Fax:310-207-3923
Practice Address - Street 1:12401 WILSHIRE BLVD
Practice Address - Street 2:STE. 304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1085
Practice Address - Country:US
Practice Address - Phone:310-979-7473
Practice Address - Fax:310-207-3923
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8882103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY8882OtherPSYCHOLOGY LICENSE NUMBER