Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95007863 | CA |
NPI | 1003328709 |
---|---|
Provider Name | Miss Sonia Sedano |
First Address | Aliso Viejo, CA 92656-5226 |
Second Address | Santa Ana, CA 92701-2304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2017 |
Last Update Date | 02/11/2017 |