Provider Demographics
NPI:1194320143
Name:SORIANO, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SORIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 BARTLETT AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3691
Mailing Address - Country:US
Mailing Address - Phone:510-398-7099
Mailing Address - Fax:
Practice Address - Street 1:730 BARTLETT AVE APT 8
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3691
Practice Address - Country:US
Practice Address - Phone:510-398-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator