Individual provider Active NPI

Vicky Jo Sorensen, M.S.

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1194910612
Registry record updated Dec 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
51439 Issued in CA
Practice address
13800 Heacock St
Ste C210
Moreno Valley, CA 92553-3339
Phone
(951) 653-0819
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 51439 CA Primary

Addresses

Primary practice location

13800 Heacock St
Ste C210
Moreno Valley, CA 92553-3339

Mailing address

PO Box 438
Crestline, CA 92325
Phone (909) 589-0657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426002744 CA Practitioner - Marriage and Family Therapist 8628418456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cyti Health PCGroup PAC ID 4587012950, 34 clinicians

Practice addresses (Care Compare)

11801 Pierce St
Riverside, CA 92505-4408
Phone (866) 478-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Mar 13, 2024 Accepting new patients
Pacific Clinics Past Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354320000000",
    "number": "1194910612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438",
            "city": "CRESTLINE",
            "state": "CA",
            "postal_code": "92325",
            "telephone_number": "909-589-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 HEACOCK ST",
            "address_2": "STE C210",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533339",
            "telephone_number": "951-653-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "VICKY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2012-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "51439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.