Healthcare Provider Details

I. General information

NPI: 1093888042
Provider Name (Legal Business Name): KIMBERLY ANNETTE SORENSEN C-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 GARDEN ST
SANTA BARBARA CA
93101-1606
US

IV. Provider business mailing address

518 GARDEN ST
SANTA BARBARA CA
93101-1606
US

V. Phone/Fax

Practice location:
  • Phone: 805-722-1511
  • Fax: 805-965-2292
Mailing address:
  • Phone: 805-722-1511
  • Fax: 805-965-2292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP14600
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9349406
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: