Individual
SHADETTE OLJOL SORIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, MSN-BC
Contact information
Practice address
7850 VISTA HILL AVE, SAN DIEGO, CA 92123-2717
(858) 836-8360
Mailing address
11526 VIA SANTA BRISA, SAN DIEGO, CA 92131-4259
(858) 414-8970
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
95022060
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95029783
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2012
Last updated
05/16/2024
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