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Individual

KEITH SOBREPENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
25000 AVENUE STANFORD STE 167, VALENCIA, CA 91355-4596
(818) 488-4840
Mailing address
10848 BALBOA BLVD, GRANADA HILLS, CA 91344-5003
(818) 488-4840

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95170749
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95021299
CA

Other

Enumeration date
06/15/2022
Last updated
10/22/2025
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