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NPI Code Detail

MEDICARE: SONYA MILBURN LPT

MEDICARE: SONYA MILBURN LPT
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
1167G00000XLicensed Psychiatric TechnicianPT29872CA

General Provider Information

NPI Number : 1356980007
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONYA MILBURN LPT
Provider Business Mailing Address
First Line : 337 S ARROYO DR APT E
Second Line :
City : SAN GABRIEL
State : CA
Zip : 91776-1043
Country : US
Telephone Number : 909-964-1087
Fax Number :
Provider Business Practice Location Address
First Line : 7500 HELLMAN AVE
Second Line :
City : ROSEMEAD
State : CA
Zip : 91770-2216
Country : US
Telephone Number : 626-288-1160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2019
Last Update Date : 12/29/2019

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