Provider Demographics
NPI:1528251378
Name:SORENSEN, REBECKAH RAY (OTR/L)
Entity type:Individual
Prefix:MR
First Name:REBECKAH
Middle Name:RAY
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:REBECKAH
Other - Middle Name:RAY
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10800 MAGNOLIA AVE.
Mailing Address - Street 2:RIVERSIDE KAISER PERMANENTE
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505
Mailing Address - Country:US
Mailing Address - Phone:951-353-4670
Mailing Address - Fax:
Practice Address - Street 1:10800 MAGNOLIA AVE.
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505
Practice Address - Country:US
Practice Address - Phone:951-353-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4312225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics