Provider Demographics
NPI:1487239786
Name:DURAN, SOPHIA MARIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:SOPHIA
Middle Name:MARIE
Last Name:DURAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 FRANCISCO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2530
Mailing Address - Country:US
Mailing Address - Phone:310-491-7070
Mailing Address - Fax:
Practice Address - Street 1:814 FRANCISCO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2530
Practice Address - Country:US
Practice Address - Phone:310-491-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016337363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily