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NPI Code Detail

MEDICARE: DR. LORI ANNE SORTINO-WILLIAMS LICENSED PH.D.

MEDICARE: DR. LORI ANNE SORTINO-WILLIAMS LICENSED PH.D.
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
1103TC0700XClinical Psychologist22686CA

General Provider Information

NPI Number : 1801022272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORI ANNE SORTINO-WILLIAMS LICENSED PH.D.
Provider Business Mailing Address
First Line : 390 N EUCLID AVE
Second Line :
City : UPLAND
State : CA
Zip : 91786-4763
Country : US
Telephone Number : 909-969-1170
Fax Number :
Provider Business Practice Location Address
First Line : 390 N EUCLID AVE
Second Line :
City : UPLAND
State : CA
Zip : 91786-4763
Country : US
Telephone Number : 909-969-1170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2009
Last Update Date : 05/30/2009

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