Provider Demographics
NPI:1205077864
Name:SORRO, JOAQUIN MATTEO
Entity type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:MATTEO
Last Name:SORRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 ANDERSON ST
Mailing Address - Street 2:137 ANDERSON
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5602
Mailing Address - Country:US
Mailing Address - Phone:415-682-3253
Mailing Address - Fax:
Practice Address - Street 1:101 15TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5103
Practice Address - Country:US
Practice Address - Phone:415-682-3253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator