Provider Demographics
NPI:1033761689
Name:SOARS, CASSANDRA
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:SOARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2183 PRINCETON WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8239
Mailing Address - Country:US
Mailing Address - Phone:530-592-7010
Mailing Address - Fax:
Practice Address - Street 1:777 AUDITORIUM DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0920
Practice Address - Country:US
Practice Address - Phone:530-592-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-14
Last Update Date:2023-09-22
Deactivation Date:2020-05-07
Deactivation Code:
Reactivation Date:2023-09-22
Provider Licenses
StateLicense IDTaxonomies
CAY6974382347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker