Individual
SOPHEA PEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7801 RUSH RIVER DR, SACRAMENTO, CA 95831-4602
(916) 393-9020
Mailing address
11113 GRAETON CIR, MATHER, CA 95655-3048
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2014
CA
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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