Individual
MS. SOPHORN SONNIE SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 E 20TH ST APT 1, LONG BEACH, CA 90806-5717
(562) 527-1093
Mailing address
1515 E 20TH ST APT 1, LONG BEACH, CA 90806-5717
(562) 527-1093
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
06/24/2024
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