Individual provider Active NPI

Amanda Nichole Sorum, NONE

  • Marriage & Family Therapist
  • Ventura, CA
National Provider Identifier
1336894260
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
162296 Issued in CA
Practice address
4667 Telegraph Rd
Ventura, CA 93003-3899
Phone
(805) 289-6346
NPI assigned
Feb 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Marriage & Family Therapist 106H00000X 162296 CA Primary

Addresses

Primary practice location

4667 Telegraph Rd
Ventura, CA 93003-3899

Mailing address

600 W Broadway Ste 300
Glendale, CA 91204-1025
Phone (818) 722-1770

Other practice location 1

600 W Broadway Ste 300
Glendale, CA 91204-1025
Phone (818) 722-1770

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

LicenseStateTypeSpecialty
162296CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ventura County Community College District Past Accepting new patients

Organizations & group practices 1

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": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1336894260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W BROADWAY STE 300",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041025",
            "telephone_number": "818-722-1770",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4667 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033899",
            "telephone_number": "805-289-6346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Broadway Ste 300",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912041025",
            "country_code": "US",
            "telephone_number": "818-722-1770",
            "fax_number": "855-568-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORUM",
        "first_name": "AMANDA",
        "middle_name": "NICHOLE",
        "credential": "NONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "162296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.