Sorrento Psychological Services, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SORRENTO PSYCHOLOGICAL SERVICES, PC

Practice address

6540 Lusk Blvd Ste C159
San Diego, CA 92121-2684

Phone

(858) 800-2236

Fax

(844) 794-7581

NPI assigned

Apr 6, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Raymod Peng, PSY.D.

Title

President

Phone

(858) 800-2236

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond Peng, PSYD

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1003123662

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1649911231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD STE C159",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212684",
            "telephone_number": "858-800-2236",
            "fax_number": "844-794-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD STE C159",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212684",
            "telephone_number": "858-800-2236",
            "fax_number": "844-794-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SORRENTO PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "RAYMOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-800-2236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Elizier Sorrell, LMFT
• Atherton L Sorrenti, D.C
• Lisa Ann Sorrentino, RN
• Sorrento Compounding LLC
• Sorrento Mesa Medical Group Professional Corporation
• Sorrento Therapeutics, Inc
• Sorrento Valley Pain Relief Center
• Anna M Sorriso, PA
• Ken Soryadvongsa
• Concepcion Sosa

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.