Provider Demographics
NPI:1689550857
Name:PAINE, SOPHIE A
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:A
Last Name:PAINE
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 1:44 VIA CORDOBA
Mailing Address - Street 2:
Mailing Address - City:RSM
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2338
Mailing Address - Country:US
Mailing Address - Phone:714-381-1391
Mailing Address - Fax:
Practice Address - Street 1:44 VIA CORDOBA
Practice Address - Street 2:
Practice Address - City:RSM
Practice Address - State:CA
Practice Address - Zip Code:92688-2338
Practice Address - Country:US
Practice Address - Phone:714-381-1391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist