Healthcare Provider Details

I. General information

NPI: 1225153810
Provider Name (Legal Business Name): MRS. SONIA MENON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SONIA MEHTA

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S FAIRMONT BLVD
ANAHEIM CA
92808-1336
US

IV. Provider business mailing address

1188 N EUCLID ST
ANAHEIM CA
92801-1900
US

V. Phone/Fax

Practice location:
  • Phone: 714-998-3272
  • Fax:
Mailing address:
  • Phone: 714-644-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: