Individual provider Active NPI

En Sorm

  • Licensed Psychiatric Technician
  • Stockton, CA
National Provider Identifier
1518076249
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
PT28784 Issued in CA
Practice address
1803 W March LN Ste Ac&D
Stockton, CA 95207-6458
Phone
(209) 636-5353
Fax
(209) 636-5356
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X PT28784 CA
Licensed Psychiatric Technician 167G00000X PT28784 CA Primary

Addresses

Primary practice location

1803 W March LN Ste Ac&D
Stockton, CA 95207-6458

Mailing address

1803 W March LN Ste Ac&D
Stockton, CA 95207-6458
Phone (209) 636-5353

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
PT28784CAMDTechnician

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1518076249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W MARCH LN STE AC&D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076458",
            "telephone_number": "209-636-5353",
            "fax_number": "209-636-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W MARCH LN STE AC&D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076458",
            "telephone_number": "209-636-5353",
            "fax_number": "209-636-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORM",
        "first_name": "EN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "CA",
            "license": "PT28784",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT28784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.