Provider Demographics
NPI:1386115137
Name:EARLEY, SONYA LORAIN (PA-C, MA, CDE)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:LORAIN
Last Name:EARLEY
Suffix:
Gender:F
Credentials:PA-C, MA, CDE
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2020 ZONAL AVENUE, IRD 626
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:323-409-6620
Mailing Address - Fax:323-226-2116
Practice Address - Street 1:2020 ZONAL AVENUE, IRD 626
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-409-6620
Practice Address - Fax:323-226-2116
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13277363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical