MEDICARE: MERCEDES LEANNE SORENSEN

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	175T00000X	Peer Specialist	HXUOSA	CA

General Provider Information

NPI Number	:	1861338428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCEDES LEANNE SORENSEN

Provider Business Mailing Address
First Line	:	630 MAGNOLIA AVE APT 202
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-1218
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 MAGNOLIA AVE APT 202
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-1218
Country	:	US
Telephone Number	:	760-382-6190
Fax Number	:

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

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “ MERCEDES LEANNE SORENSEN ” Practice Location

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