Healthcare Provider Details

I. General information

NPI: 1669387692
Provider Name (Legal Business Name): CATHERINE ELAINE SORRENTINO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY DR
CAMARILLO CA
93012-8599
US

IV. Provider business mailing address

707 CEDAR POINT PL
WESTLAKE VILLAGE CA
91362-5423
US

V. Phone/Fax

Practice location:
  • Phone: 240-434-9006
  • Fax:
Mailing address:
  • Phone: 240-434-9006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: