=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942496393
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MISS SOPHIA NEWTON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2007
-----------------------------------------------------
Last Update Date | 09/19/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 SANTA BARBARA RD
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523-4215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-890-3086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 638 MT OLIVET CT
-----------------------------------------------------
City | CLAYTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94517-1608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-673-6252
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------