Active NPI
Angel Sorensen
- Behavior Technician
- Medford, OR
National Provider Identifier
1578299517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1915 Hazel Ave
Medford, OR 97501-1630 - Phone
- (541) 476-2373
- NPI assigned
- Jul 30, 2022
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OR | ||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1915 Hazel Ave
Medford, OR 97501-1630
Mailing address
1215 SW G St
Grants Pass, OR 97526-2544
Phone (541) 476-2373
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | angelsorensen@centerforautism.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1578299517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 SW G ST",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975262544",
"telephone_number": "541-476-2373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 HAZEL AVE",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975011630",
"telephone_number": "541-476-2373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "ANGEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-30",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "angelsorensen@centerforautism.com",
"affiliation": "N",
"address_1": "3709 Citation Way Ste 102",
"city": "Medford",
"state": "OR",
"country_code": "US",
"postal_code": "975049022",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.