MEDICARE: TAYLOR SORENSON PSY. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1386290294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR SORENSON PSY. D.

Provider Business Mailing Address
First Line	:	3351 W ROCK CREEK RD STE 120
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-2463
Country	:	US
Telephone Number	:	405-801-2840
Fax Number	:	405-701-5950

Provider Business Practice Location Address
First Line	:	12301 WILSHIRE BLVD STE 413
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1051
Country	:	US
Telephone Number	:	323-375-5272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2019
Last Update Date	:	10/02/2025

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