Provider Demographics
NPI:1962750398
Name:ROCK, SONYA RENA (LCSW)
Entity type:Individual
Prefix:MS
First Name:SONYA
Middle Name:RENA
Last Name:ROCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90307-0911
Mailing Address - Country:US
Mailing Address - Phone:714-394-4585
Mailing Address - Fax:
Practice Address - Street 1:300 E HILLCREST BLVD
Practice Address - Street 2:#911
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-9997
Practice Address - Country:US
Practice Address - Phone:714-394-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 276971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical