Provider Demographics
NPI:1366621856
Name:SERNA, SONIA VANESSA (BS)
Entity type:Individual
Prefix:MS
First Name:SONIA
Middle Name:VANESSA
Last Name:SERNA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 SLATER AVE
Mailing Address - Street 2:SUITE 241
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4733
Mailing Address - Country:US
Mailing Address - Phone:714-378-2620
Mailing Address - Fax:714-378-2631
Practice Address - Street 1:10101 SLATER AVE
Practice Address - Street 2:SUITE 241
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4733
Practice Address - Country:US
Practice Address - Phone:714-378-2620
Practice Address - Fax:714-378-2631
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW310581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical