Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sofia Antonia De Sousa

Individual provider Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1649129347

Sofia Antonia De Sousa is an Emotionally Disturbed Childrens' Residential Treatment Facility in Medford, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2026

Practice location Address checks out

510 W 11th St
Medford, OR 97501-3555
Phone: (541) 613-0084
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X (OR)

Record details

NPI number1649129347
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 26, 2026
Last updated in NPPESJanuary 26, 2026
Certification dateJanuary 26, 2026
Mailing address2981 State St Apt 71, Medford, OR 97504-8451

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