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NPI Code Detail

MEDICARE: LISA ANN JORGENSEN

MEDICARE: LISA ANN JORGENSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist131750CA
2101YP2500XProfessional Counselor17236CA

General Provider Information

NPI Number : 1225646102
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN JORGENSEN
Provider Business Mailing Address
First Line : 24001 CALLE DE LA MAGDALENA UNIT 3253
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92654-1250
Country : US
Telephone Number : 657-210-2331
Fax Number :
Provider Business Practice Location Address
First Line : 27281 LAS RAMBLAS STE 208
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-8303
Country : US
Telephone Number : 657-210-2331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2020
Last Update Date : 02/16/2026

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Directions to “ LISA ANN JORGENSEN ” Practice Location

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