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NPI Code Detail

MEDICARE: SOPHIA HANSEN

MEDICARE: SOPHIA HANSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1114040532
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA HANSEN
Provider Business Mailing Address
First Line : 3601 PACIFIC AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95211-0110
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 405 E PINE ST
Second Line :
City : STOCKTON
State : CA
Zip : 95204-5522
Country : US
Telephone Number : 209-464-5519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 03/21/2025

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Directions to “ SOPHIA HANSEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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