Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LCS6265 | CA |
NPI | 1003023490 |
---|---|
Provider Name | Prof. Adelina Ruth Sorkin |
First Address | Los Angeles, CA 90039-3042 |
Second Address | Pasadena, CA 91104-2300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LCS6265 | LIC CLINICAL SOCIAL WORK (01) | CA |