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1891384566
SOPHANNY LONG SOURM
ORANGE, CA
NPI
1891384566
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 95044680)
Enumeration Date
2021-01-15
Last Update Date
2023-12-12
Business Address
SOPHANNY LONG SOURM
265 S ANITA DR STE 102-104
ORANGE, CA 92868-3355
Phone number: 310-945-3350
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Mailing Address
SOPHANNY LONG SOURM
9808 VENICE BLVD STE 700
CULVER CITY, CA 90232-6824
Phone number: 310-945-3350
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