Healthcare Provider Details
I. General information
NPI: 1134068653
Provider Name (Legal Business Name): SORENA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 N CENTRAL AVE STE 1800
PHOENIX AZ
85004-2139
US
IV. Provider business mailing address
2 N CENTRAL AVE STE 1800
PHOENIX AZ
85004-2139
US
V. Phone/Fax
- Phone: 520-447-1606
- Fax: 520-244-3835
- Phone: 520-447-1606
- Fax: 520-244-3835
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRANDON
TOBIN
Title or Position: CEO
Credential:
Phone: 520-447-1606