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Sophanny Long Sourm
Psychiatric/Mental Health Registered Nurse in Orange, California
NPI 1891384566

Sophanny Long Sourm is a Psychiatric/Mental Health Registered Nurse based in Culver City, CA and is specialized in Psychiatric/Mental Health. Sophanny Long Sourm practices in Orange, CA. The NPI Number for Sophanny Long Sourm is 1891384566 and holds a License No. 95044680 (California).

The current practice location address for Sophanny Long Sourm is 265 S Anita Dr Ste 102-104, Orange, CA and can be reached out via phone at 310-945-3350 and via fax at 310-945-3356.

Location: 265 S Anita Dr Ste 102-104, Orange, CA, 90232-6824
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891384566
Provider Name
Sophanny Long Sourm
Credential
Provider Entity Type
Individual
Gender
Female
Address
265 S Anita Dr Ste 102-104, Orange, CA, 90232-6824
Phone Number
310-945-3350
Fax Number
310-945-3356
Provider Enumeration Date
01/15/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
265 S Anita Dr Ste 102-104
City
Orange
State
California
Zip
92868-3355
Phone Number
310-945-3350
Fax Number
310-945-3356
person
Provider Business Mailing Address Details
Address
265 S Anita Dr Ste 102-104
City
Orange
State
California
Zip
92868-3355
Phone Number
310-945-3350
Fax Number
310-945-3356
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health
Taxonomy
163WP0808X
License No.
95044680 (California)
Definition
Definition to come...
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