Provider Demographics
NPI:1548070931
Name:NUNO, SOPHIA GUADALUPE
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:GUADALUPE
Last Name:NUNO
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 1:2262 FIR ST
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:CA
Mailing Address - Zip Code:95953-2451
Mailing Address - Country:US
Mailing Address - Phone:916-583-1228
Mailing Address - Fax:
Practice Address - Street 1:1526 PLUMAS CT STE 400
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2961
Practice Address - Country:US
Practice Address - Phone:530-443-9151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician