Provider Demographics
NPI:1992759195
Name:SORKIN, JOANETTE (MD)
Entity type:Individual
Prefix:
First Name:JOANETTE
Middle Name:
Last Name:SORKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BODIN CIR.
Mailing Address - Street 2:60MDOS/SGOH
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535
Mailing Address - Country:US
Mailing Address - Phone:707-423-3489
Mailing Address - Fax:707-423-5144
Practice Address - Street 1:101 BODIN CIR.
Practice Address - Street 2:60MDOS/SGOH
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535
Practice Address - Country:US
Practice Address - Phone:707-423-3489
Practice Address - Fax:707-423-5144
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK46722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry