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General NPI Number Information
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NPI Number | 1790694677
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Entity Type | Organization
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Legal Business Name | SONNY INDEPENDENT LIVING LLC
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 15440 UTAH ST
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City | CLEARLAKE
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State | CA
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Zip | 95422-8384
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Country | US
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Telephone | 510-932-0196
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5103
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City | CONCORD
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State | CA
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Zip | 94524-0103
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Country | US
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Telephone | 510-932-0196
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CHERYL SWANK
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Credential | CEO
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Telephone | 510-932-0196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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