Active NPI
Caitlin Sorenson, PSYD.
- Clinical Psychologist
- West Haven, CT
National Provider Identifier
1114261120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PENDING
- Practice address
- 950 Campbell Ave
West Haven, CT 06516-2770 - Phone
- (267) 334-3598
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | PENDING | CT | Primary |
Addresses
Primary practice location
950 Campbell Ave
West Haven, CT 06516-2770
Mailing address
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 860-5887
Other practice location 1
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 860-5887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01261511 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | CT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1114261120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 SCHRADER BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900286213",
"telephone_number": "323-860-5887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 CAMPBELL AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162770",
"telephone_number": "267-334-3598"
}
],
"practiceLocations": [
{
"address_1": "1625 Schrader Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900286213",
"country_code": "US",
"telephone_number": "323-860-5887",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SORENSON",
"first_name": "CAITLIN",
"name_prefix": "Dr.",
"credential": "PSYD.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "PENDING",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01261511",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.